Feasibility of saline immersion therapeutic endoscopy (underwater ESD) in the gastrointestinal tract: Feasibility data from a German center

Aims Endoscopic submucosal dissection (ESD) has become an established method for the ablation of early neoplasia in the gastrointestinal tract (GIT). A further development of ESD is the so-called Saline Immersion Therapeutic Endoscopy (SITE), in which the lesion is removed under isotonic saline solution. Possible advantages include faster entry into the submucosa and a lower intraprocedural complication rate, particularly bleeding into the submucosa. The aim of this work is to demonstrate the feasibility of SITE in all sections of the gastrointestinal tract

Methods This study is a retrospective evaluation of a prospectively managed database at a German high-volume center. Neoplasms that were resected with SITE were evaluated.

Results Between September 2023 and November 2024, a total of 36 lesions were resected using SITE (11 esophageal, 3 gastric, 16 colonic, 6 rectal). The median lesion size was 40 x 30 mm, with an average procedure time of 77 minutes. The complication rate was 2.8% (1/36), en bloc resection rate 100% (36/36), curative R0 resection rate 94.4% (34/36), and recurrence rate 2.8% (1/36)

Conclusions SITE or underwater ESD is feasible in the hands of an experienced endoscopist and is associated with a high technical and clinical success rate in all sections of the GIT.

Publikationsverlauf

Artikel online veröffentlicht:
27. März 2025