Endoscopy 2019; 51(04): S106
DOI: 10.1055/s-0039-1681482
ESGE Days 2019 oral presentations
Saturday, April 6, 2019 11:00 – 13:00: ESD stomach 2 Club A
Georg Thieme Verlag KG Stuttgart · New York

HOW ENDOSCOPIC SUBMUCOSAL DISSECTION FOR GASTROINTESTINAL LESIONS IS BEING IMPLEMENTED? RESULTS OF AN INTERNATIONAL SURVEY

M Araújo-Martins
1   Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
,
P Pimentel-Nunes
1   Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
2   Gastroenterology Department, Oncology Portuguese Institute of Porto, University of Porto, Porto, Portugal
3   Center for Research in Health Technologies and Information Systems (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal
,
D Libânio
2   Gastroenterology Department, Oncology Portuguese Institute of Porto, University of Porto, Porto, Portugal
3   Center for Research in Health Technologies and Information Systems (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal
,
M Borges-Canha
1   Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
,
M Dinis-Ribeiro
2   Gastroenterology Department, Oncology Portuguese Institute of Porto, University of Porto, Porto, Portugal
3   Center for Research in Health Technologies and Information Systems (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal
› Institutsangaben
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
18. März 2019 (online)

Auch verfügbar auf
 

Aims:

Superficial gastrointestinal (GI) neoplasms can be treated with endoscopic mucosal resection (EMR) and/or endoscopic submucosal dissection (ESD). These techniques are widely used in Eastern countries but experience is more limited in West. In 2010, our group found that ESD was performed only at few centers, with most endoscopists performing a low number of procedures. The aim of this study was to evaluate the current implementation of ESD in Western countries.

Methods:

Western endoscopists (n = 279) publishing between 2005 and 2017 papers related to EMR/ESD were asked to complete an online survey from December 2017 to February 2018.

Results:

A total of 58 endoscopists (21%) completed the survey. Thirty performed ESD in the esophagus (52%), 45 in the stomach (78%), 36 in the colorectum (62%), and 6 in the duodenum (10%). The median total number of lesions ever resected was > 200, with a median number per endoscopist in 2016 of 41 (7, 6 and 28 in esophagus, in the stomach and in the colon and rectum, respectively). En-bloc resection rates were 97% in the esophagus, 95% in the stomach and 84% in the colorectum. Complete resection (R0) was achieved in 88%, 91%, and 81%, respectively. Curative rates were 69%, 70% and 67%, respectively. Major complications (perforation or delayed bleeding) occurred more often in colorectal ESD (12% vs. 6% in the esophagus and 7% in the stomach). In the upper GI tract, the majority of resected lesions were intramucosal adenocarcinoma (59% in the esophagus; 47% in the stomach), while in the colorectum the majority were adenomas (59%).

Conclusions:

ESD seems to be performed by a great number of centers and endoscopists. Our results suggest that ESD is being successfully implemented in Western countries, achieving a good rate of efficacy and safety according to European guidelines.