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Prepare3D/P3D.Application of endoscopic submucosal dissection (ESD) for various gastrointestinal lesions: the need for appropriate lesion size assessment.
Endoscopic submucosal dissection (ESD) is a useful and established therapeutic procedure for gastric and colorectal adenocarcinomas and early gastric carcinomas, which were previously treated by endoscopic mucosal resection (EMR). To investigate the feasibility of performing ESD for various gastrointestinal (GI) lesions, we assessed the incidence and incidence density of various GI lesions in a 10-year period at our institution. We also assessed the resection rate and complication rate of ESD for various GI lesions. We retrospectively reviewed a total of 1,085 lesions in 914 patients who underwent ESD at our institution from January 2003 to December 2012. The median follow-up period for these patients was 30 months. The incidence and incidence density of esophageal lesions were 0.10 and 0.08 per patient-year, respectively. The most common esophageal lesions were adenocarcinoma (n = 20) and adenoma (n = 19). The median lesion size was 30 mm (range 10-70 mm). The median resection time was 37 minutes (range 5-1,049 minutes), and the overall complication rate was 6.6 % (n = 75). Five cases of pulmonary metastasis occurred after treatment for esophageal adenocarcinoma. For gastric lesions, the median lesion size was 11 mm (range 2-70 mm), and the most common gastric lesion was adenocarcinoma (n = 108) followed by mucosal depressed lesion (
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