Endoscopic Submucosal Dissection

 

 Permissions and Reprints

Introduction

Endoscopic submucosal dissection (ESD) was developed in Japan as a treatment for early gastric cancer (EGC). This technique allows en-bloc resection of the lesions [1] which has demonstrated to be crucial because the local recurrence rate when this is not possible is of 15 % [2]. Nowadays, there is a huge experience with ESD in Eastern countries where this technique is considered the gold standard treatment for EGC [3] [4]. Indications for ESD have expanded to lesions in other locations (esophagus and colon) and other types of lesions (submucosal tumors). However, the introduction of ESD in Europe and the United States of America has been and still is very slow. The aim of this guideline is to familiarize Spanish endoscopists and gastroenterologists not only with the general indications of the procedure and possilble complications but also the dedicated tools.

• References

• 1 Korenaga D, Haraguchi S, Tsujitani S et al. Clinicopathological features of mucosal carcinoma of the stomach with lymph node metastasis in eleven patients. Br J Surg 1986; 73: 431-433
  CrossrefPubMedGoogle Scholar
• 2 Tanabe S, Koizumi W, Higuchi K et al. Clinical outcome of endoscopic aspiration mucosectomy for early stage gastric cancer. Gastrointest Endosc 2002; 56: 708-713
  CrossrefPubMedGoogle Scholar
• 3 Rembacken BJ, Gotoda T, Fujii T et al. Endoscopic mucosal resection. Endoscopy 2001; 33: 709-718
  Article in Thieme ConnectPubMedGoogle Scholar
• 4 Soetikno RM, Gotoda T, Nakanishi Y et al. Endoscopic mucosal resection. Gastrointest Endosc 2003; 57: 567-579
  CrossrefPubMedGoogle Scholar
• 5 Edge SB, Byrd DR, Compton CC et al., eds. AJCC Cancer Staging Manual. 7. th ed. New York: Springer-Verlag; 2009: 103-115
  Google Scholar
• 6 The Japan Esophageal Society. Guide Lines of the Clinical and Pathologic Studies on Carcinoma of the esophagus. Tokyo: Kanehara; 2007
  CrossrefGoogle Scholar
• 7 Muto M. Endoscopic diagnostic strategy of superficial esophageal squamous cell carcinoma. Digestive Endoscopy 2013; 25: 1-6
  PubMedGoogle Scholar
• 8 Oyama T. Diagnostic strategies of superficial Barrett’s esophageal cancer for endoscopic submucosal dissection. Digestive Endoscopy 2013; 25: 7-12
  PubMedGoogle Scholar
• 9 Parkin DM, Bray F, Ferlay J et al. Global cancer statistics, 2002. CA Cancer J Clin 2005; 55: 74-108
  Google Scholar
• 10 Shimizu Y, Takahashi M, Yoshida T et al. Endoscopic resection (endoscopic mucosal resection/endoscopic submucosal dissection) for superficial esophageal squamous cell carcinoma: Current status of various techniques. Digestive Endoscopy 2013; 25: 13-19
  PubMedGoogle Scholar
• 11 Koike T, Nakagawa K, Iijima K et al. Endoscopic resection (endoscopic submucosaldissection/endoscopic mucosal resection) for superficial Barrett’s esophageal cancer. Digestive Endoscopy 2013; 25: 20-28
  PubMedGoogle Scholar
• 12 Enestvedt BK, Ginsberg GG. Advances in Endoluminal Therapy for Esophageal Cancer. Gastrointest Endoscopy Clin N Am 2013; 23: 17-39
  CrossrefPubMedGoogle Scholar
• 13 Ishihara R, Iishi H, Uedo N et al. Comparison of EMR and endoscopic submucosal dissection for en bloc resection of early esophageal cancers in Japan. Gastrointest Endosc 2008; 68: 1066-1072
  CrossrefPubMedGoogle Scholar
• 14 Takahashi H, Arimura Y, Masao H et al. Endoscopic submucosal dissection is superior to conventional endoscopic resection as a curative treatment for early squamous cell carcinoma of the esophagus (with video). Gastrointest Endosc 2010; 72: 255-264
  CrossrefPubMedGoogle Scholar
• 15 Westerterp M, Koppert LB, Buskens CJ et al. Outcome of surgical treatment for early adenocarcinoma of the esophagus or gastro-esophageal junction. Virchows Arch 2005; 446: 497-504
  CrossrefPubMedGoogle Scholar
• 16 van Vilsteren FGI, Alvarez Herrero L, Pouw RE et al. Predictive factors for initial treatment response after circumferential radiofrequency ablation for Barrett’s esophagus with early neoplasia: a prospective multicenter study. Endoscopy 2013; 45: 516-525
  Article in Thieme ConnectPubMedGoogle Scholar
• 17 Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma, 2nd English Ed. Gastric Cancer 1998; 1: 10-24
  CrossrefPubMedGoogle Scholar
• 18 Committee of Photofluorography. Standardized method of gastric photofluorography (in Japanese). J Jpn Soc Gastroenterol. Mass Survey 1984; 62: 63
  PubMedGoogle Scholar
• 19 Okamura T, Tsujitani S, Korenaga D et al. Lymphadenectomy for cure in patients with early gastric cancer and lymph node metastasis. Am J Surg 1988; 155: 476-480
  CrossrefPubMedGoogle Scholar
• 20 Sasako M, Kinoshita T, Maruyama K. Prognosis of early gastric cancer (in Japanese with English abstract). Stomach Intestine 1993; 28: 139-146
  PubMedGoogle Scholar
• 21 Gotoda T. Endoscopic resection of early gastric cancer. Gastric Cancer 2007; 10: 1-11
  CrossrefPubMedGoogle Scholar
• 22 Takenaka R, Kawahara Y, Okada H et al. Risk factors associated with local recurrence of early gastric cancers after endoscopic submucosal dissection. Gastrointest Endosc 2008; 68: 887-894
  CrossrefPubMedGoogle Scholar
• 23 Kunisaki C, Shimada H, Nomura M et al. Therapeutic strategy for signet ring cell carcinoma of the stomach. Br J Surg 2004; 91: 1319-1324
  CrossrefPubMedGoogle Scholar
• 24 Park YD, Chung YJ, Chung HY et al. Factors related to lymph node metastasis and the feasibility of endoscopic mucosal resection for treating poorly differentiated adenocarcinoma of the stomach. Endoscopy 2008; 40: 7-10
  Article in Thieme ConnectPubMedGoogle Scholar
• 25 Takizawa KST, Nakanishi Y, Taniguchi H et al. Expanded indication for endoscopic resection from the pathological viewpoint: the possibility of SM invasion by undifferentiated-type early gastric cancer. Stomach and Intestine 2006; 41: 9-17
  PubMedGoogle Scholar
• 26 Ye BD, Kim SG, Lee JY et al. Predictive factors for lymph node metastasis and endoscopic treatment strategies for undifferentiated early gastric cancer. J Gastroenterol Hepatol 2008; 23: 46-50
  CrossrefPubMedGoogle Scholar
• 27 Kang HJ, Kim DH, Jeon TY et al. Lymph node metastasis from intestinal-type early gastric cancer: experience in a single institution and reassessment of the extended criteria for endoscopic submucosal dissection. Gastrointest Endosc 2010; 72: 508-515
  CrossrefPubMedGoogle Scholar
• 28 Lee TH, Cho JY, Chang YW et al. Appropriate indications for endoscopic submucosal dissection of early gastric cancer according to tumor size and histologic type. Gastrointest Endosc 2010; 71: 920-926
  CrossrefPubMedGoogle Scholar
• 29 Hirasawa K, Kokawa A, Oka H et al. Risk assessment chart for curability of early gastric cancer with endoscopic submucosal dissection. Gastrointest Endosc 2011; 74: 1268-1275
  CrossrefPubMedGoogle Scholar
• 30 Tokioka S, Umegaki E, Murano M et al. Utility and problems of endoscopic submucosal dissection for early gastric cancer in elderly patients. Journal of Gastroenterology and Hepatology 2012; 27: 63-69
  CrossrefPubMedGoogle Scholar
• 31 Abe N, Gotoda T, Hirasawa T et al. Multicenter study of the long-term outcomes of endoscopic submucosal dissection for early gastric cancer in patients 80 years of age or older. Gastric Cancer 2012; 15: 70-75
  PubMedGoogle Scholar
• 32 Lim JH, Kim SG, Kim JW. Do antiplatelets increase the risk of bleeding after endoscopic submucosal dissection of gastric neoplasms?. Gastrointest Endosc 2012; 75: 719-727
  CrossrefPubMedGoogle Scholar
• 33 Cho SJ, Choi IJ, Kim CG et al. Aspirin use and bleeding risk after endoscopic submucosal dissection in patients with gastric neoplasms. Endoscopy 2012; 44: 114-121
  Article in Thieme ConnectPubMedGoogle Scholar
• 34 Endoscopic Classification Review Group. Update on the paris classification of superficial neoplastic lesions in the digestive tract. Endoscopy 2005; 37: 570-578
  Article in Thieme ConnectPubMedGoogle Scholar
• 35 Kudo S. Endoscopic mucosal resection of flat and depressed early colorectal cancer. Endoscopy 1993; 25: 455-461
  Article in Thieme ConnectPubMedGoogle Scholar
• 36 Fu K, Sano Y, Kato S et al. Hazards of endoscopic biopsy for flat adenoma before endoscopic mucosal resection. Dig Dis Sci 2005; 50: 1324-1327
  CrossrefPubMedGoogle Scholar
• 37 Kitajima K, Fujimori T, Fujii S et al. Correlations between lymph node metastasis and depth of submucosal invasion in submucosal invasive colorectal carcinoma: a Japanese collaborative study. J Gastroenterol 2004; 39: 534-543
  PubMedGoogle Scholar
• 38 Egashira Y, Yoshida T, Hirata I et al. Analysis of pathological risk factors for lymph node metastasis of submucosal invasive colon cancer. Mod Pathol 2004; 17: 503-511
  CrossrefPubMedGoogle Scholar
• 39 Ueno H, Mochizuki H, Hashiguchi Y et al. Risk factors for an adverse outcome in early invasive colorectal carcinoma. Gastroenterol 2004; 127: 385-394
  CrossrefPubMedGoogle Scholar
• 40 Watanabe T, Itabashi M, Shimada Y et al. Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2010 for the treatment of colorectal cancer. Int J Clin Oncol 2012; 17: 1-29
  CrossrefPubMedGoogle Scholar
• 41 Tanaka S, Oka S, Kaneko I et al. Endoscopic submucosal dissection for colorectal neoplasia: possibility of standardization. Gastrointest Endosc 2007; 66: 100-107
  CrossrefPubMedGoogle Scholar
• 42 Saito Y, Sakamoto T, Fukunaga S et al. Endoscopic submucosal dissection (ESD) for colorectal tumors. Dig Endosc 2009; 21: 7-12
  PubMedGoogle Scholar
• 43 Repici A, Hassan C, De Paula Pessoa D et al. Efficacy and safety of endoscopic submucosal dissection for colorectal neoplasia: a systematic review. Endoscopy 2012; 44: 137-150
  Article in Thieme ConnectPubMedGoogle Scholar
• 44 Lee SH, Lee KS, Park YS et al. Submucosal saline-epinephrine injection in colon polypectomy: appropriate indication. Hepatogastroenterology 2008; 55: 1589-1593
  PubMedGoogle Scholar
• 45 Dobrowolski S, Dobosz M, Babicki A et al. Prophylactic submucosal saline-adrenaline injection in colonoscopic polypectomy: prospective randomized study. Surg Endosc 2004; 18: 990-993
  CrossrefPubMedGoogle Scholar
• 46 Hsieh YH, Lin HJ, Tseng GY et al. Is submucosal epinephrine injection necessary before polypectomy? A prospective, comparative study. Hepatogastroenterology 2001; 48: 1379-1382
  PubMedGoogle Scholar
• 47 Onken JE, Friedman JY, Subramanian S et al. Treatment patterns and costs associated with sessile colorectal polyps. Am J Gastroenterol 2002; 97: 2896-2901
  CrossrefPubMedGoogle Scholar
• 48 Caravati-Jouvenceaux A, Launoy G, Klein D et al. Health-related quality of life among long-term survivors of colorectal cancer: a population-based study. Oncologist 2011; 16: 1626-1636
  CrossrefPubMedGoogle Scholar
• 49 Gall CA, Weller D, Esterman A et al. Patient satisfaction and health-related quality of life after treatment for colon cancer. Dis Colon Rectum 2007; 50: 801-809
  CrossrefPubMedGoogle Scholar
• 50 Arditi C, Gonvers JJ, Burnand B et al. Appropriateness of colonoscopy in Europe (EPAGE II); surveillance after polypectomy and after resection of colorectal cancer. Endoscopy 2009; 41: 209-217
  Article in Thieme ConnectPubMedGoogle Scholar
• 51 Bourke MJ. Endoscopic resection in the duodenum: current limitations and future directions. Endoscopy 2013; 45: 127-132
  Article in Thieme ConnectPubMedGoogle Scholar
• 52 Kim KO, Kim SJ, Kim TH et al. Do you have what it takes for challenging endoscopic submucosal dissection cases?. World J Gastroenterol 2011; 17: 3580-3584
  CrossrefPubMedGoogle Scholar
• 53 Lépilliez V, Chemaly M, Ponchon T et al. Endoscopic resection of sporadic duodenal adenomas: an efficient technique with a substantial risk of delayed bleeding. Endoscopy 2008; 40: 806-810
  Article in Thieme ConnectPubMedGoogle Scholar
• 54 Apel D, Jakobs R, Spiethoff A et al. Follow-up after endoscopic snare resection of duodenal adenomas. Endoscopy 2005; 37: 444-448
  Article in Thieme ConnectPubMedGoogle Scholar
• 55 Shimizu Y, Yamamoto J, Kato M et al. Endoscopic submucosal dissection for treatment of early stage hypopharyngeal carcinoma. Gastrointest Endosc 2006; 64: 255-259
  CrossrefPubMedGoogle Scholar
• 56 Iizuka T, Kikuchi D, Hoteya S et al. Clinical advantage of endoscopic submucosal dissection over endoscopic mucosal resection for early mesopharyngeal and hypopharyngeal cancers. Endoscopy 2011; 43: 839-843
  Article in Thieme ConnectPubMedGoogle Scholar
• 57 Huang ZG, Zhang XS, Huang SL et al. Endoscopy dissection of small stromal tumors emerged from the muscularis propria in the upper gastrointestinal tract: Preliminary study. World J Gastrointest Endosc 2012; 4: 565-570
  CrossrefPubMedGoogle Scholar
• 58 Onozato Y, Kakizaki S, Iizuka H et al. Endoscopic submucosal dissection for rectal carcinoid tumors. Dis Colon Rectum 2010; 53: 169-176
  CrossrefPubMedGoogle Scholar
• 59 Toyonaga T, Nishino E, Man M et al. Principles of Quality Controlled Endoscopic Submucosal Dissection with Appropriate Dissection Level and High Quality Resected Specimen. Clin Endosc 2012; 45: 362-374
  CrossrefPubMedGoogle Scholar
• 60 Matsui N, Akahoshi K, Nakamura K et al. Endoscopic submucosal dissection for removal of superficial gastrointestinal neoplasms: A technical review. World J Gastrointest Endosc 2012; 4: 123-136
  CrossrefPubMedGoogle Scholar
• 61 Lee BI. Indications, Knives, and Electric Current: What’s the Best?. Clin Endosc 2012; 45: 285-287
  CrossrefPubMedGoogle Scholar
• 62 Rosenberg N, New Brunswick NJ. Submucosal saline wheal as safety factor in fulguration of rectal and sigmoidal polipy. Arch Surg 1955; 70: 120-122
  CrossrefPubMedGoogle Scholar
• 63 Fujishiro M, Yahagi N, Kashimura K et al. Comparison of various submucosal injection solutions for maintaining mucosal elevation during endoscopic mucosal resection. Endoscopy 2004; 36: 579-583
  Article in Thieme ConnectPubMedGoogle Scholar
• 64 Giday SA, Magno P, Buscaglia JM et al. Is blood the ideal submucosal cushioning agent? A comparative study in a porcine model. Endoscopy 2006; 38: 1230-1234
  Article in Thieme ConnectPubMedGoogle Scholar
• 65 Yeh RW, Triadafilopoulos G. Submucosal injection: safety cushion at what cost?. Gastrointest Endosc 2005; 62: 943-945
  CrossrefPubMedGoogle Scholar
• 66 Conio M, Rajan E, Sorbi D et al. Comparative performance in the porcine esophagus of different solutions used for mucosal injection. Gastrointest Endosc 2002; 56: 513-516
  CrossrefPubMedGoogle Scholar
• 67 Hyun JJ, Chun HR, Chun HJ et al. Comparison of the characteristics of submucosal injection solutions used in endoscopic mucosal resection. Scand J Gastroenterol 2006; 41: 488-492
  CrossrefPubMedGoogle Scholar
• 68 Kantsevoy SV, Adler DG, Conway JD. ASGE technology committee et al. Endoscopic mucosal resection and endoscopic submucosal dissection. Gastrointest Endosc 2008; 68: 11-8
  CrossrefPubMedGoogle Scholar
• 69 Matsui Y, Inomata M, Izumi K et al. Hyaluronic acid stimulates tumor-cell proliferation at wound sites. Gastrointest Endosc 2004; 60: 539-543
  CrossrefPubMedGoogle Scholar
• 70 Bures J, Kopácová M, Kvetina J et al. Different solutions used for submucosal injection influenced early healing of gastric endoscopic mucosal resection in a preclinical study in experimental pigs. Surg Endosc 2009; 23: 2094-2101
  CrossrefPubMedGoogle Scholar
• 71 Yamamoto H, Yube T, Isoda N et al. A novel method of endoscopic mucosal resection using sodium hyaluronate. Gastrointest Endosc 1999; 50: 251-256
  CrossrefPubMedGoogle Scholar
• 72 Lee SH, Cho WY, Kim HJ et al. A new method of EMR: submucosal injection of a fibrinogen mixture. Gastrointest Endosc 2004; 59: 220-224
  CrossrefPubMedGoogle Scholar
• 73 Uraoka T, Fujii T, Saito Y et al. Effectiveness of glycerol as a submucosal injection for EMR. Gastrointest Endosc 2005; 61: 736-740
  CrossrefPubMedGoogle Scholar
• 74 http://www.vademecum.es/medicamento-hyalgan_ficha_22180
  PubMed
• 75 Sumiyoshi T, Fuji TM, Sumiyoshi Y et al. Injected substances to the submucosa in endoscopic mucosal resection: glycerin solution versus normal saline solution [abstract]. Gastrointest Endosc 2002; 55 AB1 10
  PubMedGoogle Scholar
• 76 Lee SH, Park JH, Park doH et al. Clinical efficacy of EMR with submucosal injection of a fibrinogen mixture: a prospective randomized trial. Gastrointest Endosc 2006; 64: 691-696
  CrossrefPubMedGoogle Scholar
• 77 Fujishiro M, Yahagi N, Kashimura K et al. Tissue damage of different submucosal injection solutions for EMR. Gastrointest Endosc 2005; 62: 933-942
  CrossrefPubMedGoogle Scholar
• 78 Polymeros D, Kotsalidis G, Triantafyllou K et al. Comparative performance of novel solutions for submucosal injection in porcine stomachs: An ex vivo study. Dig Liv Dis 2010; 42: 226-229
  CrossrefPubMedGoogle Scholar
• 79 Feitoza AB, Gostout CJ, Burgart LJ et al. Hydroxypropyl methylcellulose: a better submucosal fluid cushion for endoscopic mucosal resection. Gastrointest Endosc 2003; 57: 41-47
  PubMedGoogle Scholar
• 80 Sato T. A novel method of endoscopic mucosal resection assisted by submucosal injection of autologous blood (blood patch EMR). Dis Colon Rectum 2006; 49: 1636-41
  CrossrefPubMedGoogle Scholar
• 81 Fernández-Esparrach G, Shaikh SN, Cohen A et al. Efficacy of a reverse-phase polymer as a submucosal injection solution for EMR: a comparative study (with video). Gastrointestinal Endoscopy 2009; 69: 1135-1139
  CrossrefPubMedGoogle Scholar
• 82 Al Taie OH, Bauer Y, Dietrich CG et al. Efficacy of submucosal injection of different solutions inclusive blood components on mucosa elevation for endoscopic resection. Clin Exp Gastroenterol 2012; 5: 43-48
  PubMedGoogle Scholar
• 83 Lenz L, Di Sena V, Nakao FS et al. Hydroxipropyl methilcellulose, Carboxymethylcellulose and normal saline solution in a porcine model. Arq Gastroenterol 2010; 47: 184-187
  CrossrefPubMedGoogle Scholar
• 84 Katsinelos P, Kontouras J, Paroutoglou G et al. A comparative study of 50% dextrose and normal saline solution on their ability to create submucosal fluid cushions for endoscopic resection of sessile rectosigmoid polyps. Gastrointestinal Endoscopy 2008; 68: 692-698
  CrossrefPubMedGoogle Scholar
• 85 Park S, Chun HJ, Kim CY et al. Electrical characteristics of various submucosal injection fluids for endoscopic mucosal resection. Dig Dis Sci 2008; 53: 1678-1682
  CrossrefPubMedGoogle Scholar
• 86 Morris ML, Tucker RD, Baron TH et al. Electrosurgery in gastrointestinal endoscopy: principles to practice. Am J Gastroenterol 2009; 104: 1563-1574
  CrossrefPubMedGoogle Scholar
• 87 Slivka A, Bosco JJ, Barkun AN et al. Technology Committee of the American Society for Gastrointestinal Endoscopy, USA Electrosurgical generators. Gastrointest Endosc 2003; 58: 656-660
  CrossrefPubMedGoogle Scholar
• 88 Toyokawa T, Inaba T, Omote S et al. Risk factors for perforation and delayed bleeding associated with endoscopic submucosal dissection for early gastric neoplasms; analysis of 1123 lesions. J Gastroenterol Hepatol 2012; 27: 907-912
  CrossrefPubMedGoogle Scholar
• 89 Gotoda T, Yamamoto H, Soetikno RM. Endoscopic submucosal dissection of early gastric cancer. J Gastroenterol 2006; 41: 929-942
  CrossrefPubMedGoogle Scholar
• 90 Oda I, Gotoda T, Hamanaka H et al. Endoscopic submucosal dissection for early gastric cancer. Technical feasibility, operation time and complications from a large consecutive series. Digestive Endoscopy 2005; 17: 54-58
  CrossrefPubMedGoogle Scholar
• 91 Lian J, Chen S, Zhang Y et al. A meta-analysis of endoscopic submucosal dissection and EMR for early gastric cancer. Gastrointest Endosc 2012; 76: 763-770
  CrossrefPubMedGoogle Scholar
• 92 Repici A, Hassan C, De Paula Pessoa D et al. Efficacy and safety of endoscopic submucosal dissection for colorectal neoplasia: a systematic review. Endoscopy 2012; 44: 137-150
  Article in Thieme ConnectPubMedGoogle Scholar
• 93 Isomoto H, Yamaguchi N, Minami H et al. Management of complications associated with endoscopic submucosal dissection/ endoscopic mucosal resection for esophageal cancer. Dig Endosc 2013; 25: 29-38
  CrossrefPubMedGoogle Scholar
• 94 Tajiri H, Kitano S. Complications associated with endoscopic mucosal resection: Definition of bleeding that can be viewed as accidental. Digestive Endoscopy 2004; 16: 134-136
  CrossrefPubMedGoogle Scholar
• 95 Toyokawa T, Inaba T, Omote S et al. Risk factors for perforation and delayed bleeding associated with endoscopic submucosal dissection for early gastric neoplasms: analysis of 1123 lesions. J Gastroenterol Hepatol 2012; 27: 907-912
  CrossrefPubMedGoogle Scholar
• 96 Watanabe Y, Kato N, Maehata T et al. Safer endoscopic gastric mucosal resection: preoperative proton pump inhibitor administration. J Gastroenterol Hepatol 2006; 21: 1675-1680
  CrossrefPubMedGoogle Scholar
• 97 Okada K, Yamamoto Y, Kasuga A et al. Risk factors for delayed bleeding after endoscopic submucosal dissection for gastric neoplasm. Surg Endosc 2011; 25: 98-107
  CrossrefPubMedGoogle Scholar
• 98 Jeon SW, Jung MK, Cho CM et al. Predictors of immediate bleeding during endoscopic submucosal dissection in gastric lesions. Surg Endosc 2009; 23: 1974-1979
  CrossrefPubMedGoogle Scholar
• 99 Takizawa K, Oda I, Gotoda T et al. Routine coagulation of visible vessels may prevent delayed bleeding after endoscopic submucosal dissection – an analysis of risk factors. Endoscopy 2008; 40: 179-183
  Article in Thieme ConnectPubMedGoogle Scholar
• 100 Ryu HY, Kim JW, Kim HS et al. Second-look endoscopy is not associated with better clinical outcomes after gastric endoscopic submucosal dissection: a prospective, randomized, clinical trial analyzed on an as-treated basis. Gastrointest Endosc 2013; 78: 285-294
  CrossrefPubMedGoogle Scholar
• 101 Muraki Y, Enomoto S, Iguchi M et al. Management of bleeding and artificial gastric ulcers associated with endoscopic submucosal dissection. World J Gastrointest Endosc 2012; 4: 1-8
  PubMedGoogle Scholar
• 102 Ono S, Kato M, Ono Y et al. Effects of preoperative administration of omeprazole on bleeding after endoscopic submucosal dissection: a prospective randomized controlled trial. Endoscopy 2009; 41: 299-303
  Article in Thieme ConnectPubMedGoogle Scholar
• 103 Yang Z, Wu Q, Liu Z et al. Proton pump inhibitors versus histamine-2-receptor antagonists for the management of iatrogenic gastric ulcer after endoscopic mucosal resection or endoscopic submucosal dissection: a meta-analysis of randomized trials. Digestion 2011; 84: 315-320
  CrossrefPubMedGoogle Scholar
• 104 Fujiwara S, Morita Y, Toyonaga T et al. A randomized controlled trial of rebamipide plus rabeprazole for the healing of artificial ulcers after endoscopic submucosal dissection. J Gastroenterol 2011; 46: 595-602
  CrossrefPubMedGoogle Scholar
• 105 Kato T, Araki H, Onogi F et al. Clinical trial: rebamipide promotes gastric ulcer healing by proton pump inhibitor after endoscopic submucosal dissection--a randomized controlled study. J Gastroenterol 2010; 45: 285-290
  CrossrefPubMedGoogle Scholar
• 106 Kobayashi Y, Kudo SE, Miyachi H et al. Clinical usefulness of pit patterns for detecting colonic lesions requiring surgical treatment. Int J Colorectal Dis 2011; 26: 1531-1540
  CrossrefPubMedGoogle Scholar
• 107 Shin WG, Kim SJ, Choi MH et al. Can rebamipide and proton pump inhibitor combination therapy promote the healing of endoscopic submucosal dissection-induced ulcers? A randomized, prospective, multicenter study. Gastrointest Endosc 2012; 75: 739-747
  CrossrefPubMedGoogle Scholar
• 108 Kakushima N, Fujishiro M, Yahagi N et al. Helicobacter pylori status and the extent of gastric atrophy do not affect ulcer healing after endoscopic submucosal dissection. J Gastroenterol Hepatol 2006; 21: 1586-1589
  CrossrefPubMedGoogle Scholar
• 109 Ueda H, Ito M, Tanaka S et al. The effect of Helicobacter pylori eradication therapy on gastric ulcer healing after endoscopic mucosal resection. J Clin Gastroenterol 2006; 40: 293-296
  CrossrefPubMedGoogle Scholar
• 110 Huang Y, Kakushima N, Takizawa K et al. Risk factors for recurrence of artificial gastric ulcers after endoscopic submucosal dissection. Endoscopy 2011; 43: 236-239
  Article in Thieme ConnectPubMedGoogle Scholar
• 111 Fukase K, Kato M, Kikuchi S et al. Effect of eradication of Helicobacter pylori on incidence of metachronous gastric carcinoma after endoscopic resection of early gastric cancer: an open-label, randomised controlled trial. Lancet 2008; 372: 392-397
  CrossrefPubMedGoogle Scholar
• 112 Maeda Y, Hirasawa D, Fujita N et al. Mediastinal emphysema after esophageal endoscopic submucosal dissection: its prevalence and clinical significance. Dig Endosc 2011; 23: 221-226
  CrossrefPubMedGoogle Scholar
• 113 Oda I, Suzuki H, Nonaka S et al. Complications of gastric endoscopic submucosal dissection. Dig Endosc 2013; 25: 71-78
  PubMedGoogle Scholar
• 114 Taku K, Sano Y, Fu KI et al. Iatrogenic perforation associated with therapeutic colonoscopy: a multicenter study in Japan. J Gastroenterol Hepatol 2007; 22: 1409-1414
  CrossrefPubMedGoogle Scholar
• 115 Minami S, Gotoda T, Ono H et al. Complete endoscopic closure of gastric perforation induced by endoscopic resection of early gastric cancer using endoclips can prevent surgery (with video). Gastrointest Endosc 2006; 63: 596-601
  CrossrefPubMedGoogle Scholar
• 116 Isomoto H, Yamaguchi N, Minami H et al. Management of complications associated with endoscopic submucosal dissection/ endoscopic mucosal resection for esophageal cancer. Dig Endosc 2013; 25: 29-38
  CrossrefPubMedGoogle Scholar
• 117 Hashimoto S, Kobayashi M, Takeuchi M et al. The efficacy of endoscopic triamcinolone injection for the prevention of esophageal stricture after endoscopic submucosal dissection. Gastrointest Endosc 2011; 74: 1389-1393
  CrossrefPubMedGoogle Scholar
• 118 Hanaoka N, Ishihara R, Takeuchi Y et al. Intralesional steroid injection to prevent stricture after endoscopic submucosal dissection for esophageal cancer: a controlled prospective study. Endoscopy 2012; 44: 1007-1011
  Article in Thieme ConnectPubMedGoogle Scholar
• 119 Wang C, Lu X, Chen P. Clinical value of preventive balloon dilatation for esophageal stricture. Exp Ther Med 2013; 5: 292-294
  PubMedGoogle Scholar
• 120 Ezoe Y, Muto M, Horimatsu T et al. Efficacy of preventive endoscopic balloon dilation for esophageal stricture after endoscopic resection. J Clin Gastroenterol 2011; 45: 222-227
  CrossrefPubMedGoogle Scholar
• 121 Yamaguchi N, Isomoto H, Nakayama T et al. Usefulness of oral prednisolone in the treatment of esophageal stricture after endoscopic submucosal dissection for superficial esophageal squamous cell carcinoma. Gastrointest Endosc 2011; 73: 1115-1121
  CrossrefPubMedGoogle Scholar
• 122 Sato H, Inoue H, Kobayashi Y et al. Control of severe strictures after circumferential endoscopic submucosal dissection for esophageal carcinoma: oral steroid therapy with balloon dilation or balloon dilation alone. Gastrointest Endosc 2013; 78: 250-257
  CrossrefPubMedGoogle Scholar
• 123 Machida H, Tominaga K, Minamino H et al. Locoregional mitomycin C injection for esophageal stricture after endoscopic submucosal dissection. Endoscopy 2012; 44: 622-625
  Article in Thieme ConnectPubMedGoogle Scholar
• 124 Ohki T, Yamato M, Ota M et al. Prevention of esophageal stricture after endoscopic submucosal dissection using tissue-engineered cell sheets. Gastroenterology 2012; 143: 582-588 e1-2.
  CrossrefPubMedGoogle Scholar
• 125 Matsumoto S, Miyatani H, Yoshida Y et al. Cicatricial stenosis after endoscopic submucosal dissection of esophageal cancer effectively treated with a temporary self-expandable metal stent. Gastrointest Endosc 2011; 73: 1309-1312
  CrossrefPubMedGoogle Scholar
• 126 Saito Y, Tanaka T, Andoh A et al. Novel biodegradable stents for benign esophageal strictures following endoscopic submucosal dissection. Dig Dis Sci 2008; 53: 330-333
  CrossrefPubMedGoogle Scholar
• 127 Coda S, Oda I, Gotoda T et al. Risk factors for cardiac and pyloric stenosis after endoscopic submucosal dissection, and efficacy of endoscopic balloon dilation treatment. Endoscopy 2009; 41: 421-426
  Article in Thieme ConnectPubMedGoogle Scholar
• 128 Tsunada S, Ogata S, Mannen K et al. Case series of endoscopic balloon dilation to treat a stricture caused by circumferential resection of the gastric antrum by endoscopic submucosal dissection. Gastrointest Endosc 2008; 67: 979-983
  CrossrefPubMedGoogle Scholar
• 129 Mori H, Kobara H, Fujihara S et al. Recanalization of severe gastric antral stricture after large endoscopic submucosal dissection: mucosal incision and local steroid injection. J Gastrointestin Liver Dis 2012; 21: 435-437
  PubMedGoogle Scholar
• 130 Ajibe H, Osawa H, Yoshizawa M et al. Phlegmonous Gastritis after Endoscopic Submucosal Dissection for early Gastric Cancer. Therap Adv Gastroenterol 2008; 1: 91-95
  CrossrefPubMedGoogle Scholar
• 131 Yang CW, Yen HH. Large gastric intramural hematoma: unusual complication of endoscopic submucosal dissection. Endoscopy 2011; 43: E240
  Article in Thieme ConnectPubMedGoogle Scholar
• 132 Hyun YS, Han DS, Lee HL et al. Gastric emphysema after endoscopic submucosal dissection. Endoscopy 2011; 43: E83-4
  Article in Thieme ConnectPubMedGoogle Scholar
• 133 Kusunoki M, Miyake K, Shindo T et al. The incidence of deep vein thrombosis in Japanese patients undergoing endoscopic submucosal dissection. Gastrointest Endosc 2011; 74: 798-804
  CrossrefPubMedGoogle Scholar
• 134 Tamiya Y, Nakahara K, Kominato K et al. Pneumomediastinum is a frequent but minor complication during esophageal endoscopic submucosal dissection. Endoscopy 2010; 42: 8-14
  Article in Thieme ConnectPubMedGoogle Scholar
• 135 Siboni S, Bona D, Abate E et al. Tension pneumoperitoneum following endoscopic submucosal dissection of leiomyoma of the cardia. Endoscopy 2010; 42: E152
  Article in Thieme ConnectPubMedGoogle Scholar
• 136 Gotoda T, Yamamoto H, Soetikno RM. Endoscopic submucosal dissection of early gastric cancer. J Gastroenterol 2006; 41: 929-942
  CrossrefPubMedGoogle Scholar
• 137 Kakushima N, Fujishiro M, Kodashima S et al. A learning curve for endoscopic submucosal dissection of gastric epithelial neoplasms. Endoscopy 2006; 38: 991-995
  Article in Thieme ConnectPubMedGoogle Scholar
• 138 Fujishiro M, Jung HY, Goda K et al. Desirable training and roles of Japanese endoscopists towards the further penetration of endoscopic submucosal dissection in Asia. Dig Endosc 2012; 24: 121-123
  PubMedGoogle Scholar
• 139 Oda I, Odagaki T, Suzuki H et al. Learning curve for endoscopic submucosal dissection of early gastric cancer based on trainee experience. Dig Endosc 2012; 24: 129-132
  CrossrefPubMedGoogle Scholar
• 140 Yamamoto S, Uedo N, Ishihara R et al. Endoscopic submucosal dissection for early gastric cancer performed by supervised residents: assessment of feasibility and learning curve. Endoscopy 2009; 41: 923-928
  Article in Thieme ConnectPubMedGoogle Scholar
• 141 Niimi K, Fujishiro M, Goto O et al. Safety and efficacy of colorectal endoscopic submucosal dissection by the trainee endoscopists. Dig Endosc 2012; 24: 154-158
  PubMedGoogle Scholar
• 142 Yamamoto Y, Fujisaki J, Ishiyama A et al. Current status of training for endoscopic submucosal dissection for gastric epithelial neoplasm at Cancer Institute Hospital, Japanese Foundation for Cancer Research, a famous Japanese hospital. Dig Endosc 2012; 24: 148-153
  CrossrefPubMedGoogle Scholar
• 143 Neuhaus H. Endoscopic submucosal dissection in the upper gastrointestinal tract: present and future view of Europe. Dig Endosc 2009; 21: 4-6
  CrossrefPubMedGoogle Scholar
• 144 Dinis-Ribeiro M, Pimentel-Nunes P, Afonso M et al. A European case series of endoscopic submucosal dissection for gastric superficial lesions. Gastrointest Endosc 2009; 69: 350-355
  CrossrefPubMedGoogle Scholar
• 145 Deprez PH, Bergman JJ, Meisner S et al. Current practice with endoscopic submucosal dissection in Europe: position statement from a panel of experts. Endoscopy 2010; 42: 853-858
  Google Scholar
• 146 Farhat S, Chaussade S, Ponchon T et al. Endoscopic submucosal dissection in a European setting. A multi-institutional report of a technique in development. Endoscopy 2011; 43: 664-670
  Article in Thieme ConnectPubMedGoogle Scholar
• 147 Toyonaga T, Man-i M, East JE et al. 1,635 Endoscopic submucosal dissection cases in the esophagus, stomach, and colorectum: complication rates and long-term outcomes. Surg Endosc 2013; 27: 1000-1008
  CrossrefPubMedGoogle Scholar
• 148 Berr F, Ponchon T, Neureiter D et al. Experimental endoscopic submucosal dissection training in a porcine model: learning experience of skilled Western endoscopists. Dig Endosc 2011; 23: 281-289
  CrossrefPubMedGoogle Scholar
• 149 Nicolas-Pérez D. Endoscopic submucosal dissection: only for expert endoscopists?. Gastroenterol Hepatol 2012; 35: 344-367
  CrossrefPubMedGoogle Scholar
• 150 Vázquez-Sequeiros E, de Miquel DB, Olcina JR et al. Training model for teaching endoscopic submucosal dissection of gastric tumors. Rev Esp Enferm Dig 2009; 101: 546-552
  PubMedGoogle Scholar
• 151 Parra-Blanco A, Arnau MR, Nicolas-Perez D et al. Endoscopic submucosal dissection training with pig models in a Western country. World J Gastroenterol 2010; 16: 2895-2900
  CrossrefPubMedGoogle Scholar
• 152 Gotoda T, Friedland S, Hamanaka H et al. A learning curve for advanced endoscopic resection. Gastrointest Endosc 2005; 62: 866-867
  CrossrefPubMedGoogle Scholar
• 153 Hon SS, Ng SS, Lee JF et al. In vitro porcine training model for colonic endoscopic submucosal dissection: an inexpensive and safe way to acquire a complex endoscopic technique. Surg Endosc 2010; 24: 2439-2443
  CrossrefPubMedGoogle Scholar
• 154 Wang TE, Wang HY, Lin CC et al. Simulating a target lesion for endoscopic submucosal dissection training in an ex vivo pig model. Gastrointest Endosc 2011; 74: 398-402
  CrossrefPubMedGoogle Scholar
• 155 Coda S, Trentino P, Antonellis F et al. A Western single-center experience with endoscopic submucosal dissection for early gastrointestinal cancers. Gastric Cancer 2010; 13: 258-263
  CrossrefPubMedGoogle Scholar