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Tan Y, Lu J, Lv L, Le M, Liu D. Current status of endoscopic submucosal tunnel dissection for treatment of superficial gastrointestinal neoplastic lesions. Expert Rev Gastroenterol Hepatol 2020; 14:453-462. [PMID: 32394748 DOI: 10.1080/17474124.2020.1766967] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION With the widespread application of screening endoscopy and development of endoscopy-related instruments, more and more gastrointestinal cancers are detected in an early stage. Endoscopic resection is a preferred method for selected patients with superficial gastrointestinal neoplastic lesions, and endoscopic submucosal dissection (ESD) has become a standard method for its ability to perform en bloc resection regardless of the lesion size. ESD can be performed in a conventional or tunneling way, and the latter is termed endoscopic submucosal tunnel dissection (ESTD). AREA COVERED In the present review, we provided a comprehensive review on ESTD for treatment of superficial gastrointestinal neoplastic lesions. We mainly focus on technical details, safety and efficacy of ESTD for esophageal, gastric and colorectal lesions. The present review is expected to provide tips for operators who are going to perform ESTD. EXPERT OPINION The best indication of ESTD is large superficial esophageal neoplastic lesions (circumferential extent > 1/3 and longitudinal extent > 3 cm). Although ESTD has shown promising primary results for superficial gastric and colorectal neoplastic lesions, it is technically difficult and should be attempted only in experienced hands. Post-treatment stricture is a major concern, and preventive measures are recommended for patients with high risk of post-ESTD stricture.
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Affiliation(s)
- Yuyong Tan
- Department of Gastroenterology, The Second Xiangya Hospital, Central South University , Changsha, Hunan, China.,Research Center of Digestive Disease, Central South University , Changsha, Hunan, China
| | - Jiaxi Lu
- Department of Gastroenterology, The Second Xiangya Hospital, Central South University , Changsha, Hunan, China.,Research Center of Digestive Disease, Central South University , Changsha, Hunan, China
| | - Liang Lv
- Department of Gastroenterology, The Second Xiangya Hospital, Central South University , Changsha, Hunan, China.,Research Center of Digestive Disease, Central South University , Changsha, Hunan, China
| | - Meixian Le
- Department of Gastroenterology, The Second Xiangya Hospital, Central South University , Changsha, Hunan, China.,Research Center of Digestive Disease, Central South University , Changsha, Hunan, China
| | - Deliang Liu
- Department of Gastroenterology, The Second Xiangya Hospital, Central South University , Changsha, Hunan, China.,Research Center of Digestive Disease, Central South University , Changsha, Hunan, China
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