Introduction of endoscopic submucosal dissection in the West

• 作者: David Friedel Stavros Nicholas Stavropoulos
• 来源期刊: 世界胃肠内镜杂志：英文版（电子版）
• 学科: 医学
• 关键词: Endoscopic SUBMUCOSAL DISSECTION Gastric CANCER Barrett’s ESOPHAGUS Endoscopy training COLON CANCER RECTAL CANCER
• 年，卷（期）: 2018,（10）
• 页码范围: 225-238
• 页数: 14页
• 分类号: R

摘要

Endoscopic submucosal dissection(ESD)is well established in Asia as a modality for selected advanced lesions of both the upper and lower gastrointestinal tract,but ESD has not attained the same niche in the West due to a variety of reasons.These include competition from traditional surgery,minimally invasive surgery and endoscopic mucosal resection.Other obstacles to ESD introduction in the West include time commitment for learning and doing procedures,a steep learning curve,special equipment,lack of mentors,cost issues,interdisciplinary conflicts,concern regarding complications and lack of support from institutions and interfacing departments.There are intrinsic differences in pathology prevalence(e.g.,early gastric cancer)between the two regions that are less conducive for ESD implementation in the West.We will elaborate on these issues and suggest measures as well as a protocol to overcome these obstacles and hopefully allow introduction of ESD as a tenable option for appropriate patients.