| Theme |
Towards Standardization of ESD Procedures |
| Title |
The Gastric ESD -- Our Treatment Strategy and Tips |
| Author |
Satoru Nonaka |
Endoscopy Division, National Cancer Center Hospital |
| Author |
Ichiro Oda |
Endoscopy Division, National Cancer Center Hospital |
| Author |
Seiichiro Abe |
Endoscopy Division, National Cancer Center Hospital |
| Author |
Haruhisa Suzuki |
Endoscopy Division, National Cancer Center Hospital |
| Author |
Shigetaka Yoshinaga |
Endoscopy Division, National Cancer Center Hospital |
| Author |
Yutaka Saito |
Endoscopy Division, National Cancer Center Hospital |
| [ Summary ] |
The gastric endoscopic submucosal dissection (ESD) has the longest history of use compared to other types of ESD for other parts of the GI tract, and it has been said to have become the standard treatment for early gastric cancer. However, only experienced endoscopists can complete the gastric ESD for technically difficult lesions located in the greater curvature of the gastric body and fornix of the stomach. Furthermore, the gastric ESD is a fight against bleeding, and hence, it is crucial to control the bleeding successfully during ESD. We apply the near‒side approach method, which combines the strategy of the ESD using a needle‒type knife and an IT knife when the gastric ESD is performed for lesions located in the gastric body. Recently, the traction method, using the clip with line technique, is known to be very effective in shortening the procedure time in the gastric ESD, particularly for lesions of the greater curvature. These strategies and tips make gastric ESD successful and high‒quality even if the procedure is technically difficult owing to the site of the lesions. |