| Theme |
Towards Standardization of ESD Procedures |
| Title |
Know-how for the Practice of Endoscopic Submucosal Dissection for the Treatment of Superficial Nonampullary Duodenal Tumors and Strategies for Preventing Adverse Events |
| Author |
Tomoaki Tashima |
Department of Gastroenterology, NTT Medical Center Tokyo |
| Author |
Ken Ohata |
Department of Gastroenterology, NTT Medical Center Tokyo / Department of Endoscopy, NTT Medical Center Tokyo |
| Author |
Hitoshi Satodate |
3Department of Surgery, NTT Medical Center Tokyo |
| Author |
Hajime Horiuchi |
4Department of Pathology, NTT Medical Center Tokyo |
| Author |
Nobuyuki Matsuhashi |
Department of Gastroenterology, NTT Medical Center Tokyo |
| [ Summary ] |
Owing to the technical difficulty and high incidence of serious adverse events associated with the procedure, endoscopic submucosal dissection (ESD) for superficial nonampullary duodenal tumors (SNADT), it is recognized as a therapeutic procedure distinct from that for lesions in other segments of the gastrointestinal tract, and it is carried out only at advanced medical facilities. It is established beyond doubt, nevertheless, that ESD is more advantageous for patients compared to surgical treatment, being a minimally invasive treatment. Further improvement of the technical skills of the endoscopists, along with various procedural modifications and instrument developments are being sought in order to allow safe and secure practice of duodenal ESD and standardization of the procedure. Recently, there have been many reports of laparoscopic and endoscopic cooperative surgery (LECS) being applied. Close cooperation with surgeons and robust backup systems are also vital while considering treatment for SNADT. |