History of endoscopic submucosal dissection and role for colorectal endoscopic submucosal dissection: A Japanese perspective

Endoscopic resection of early gastric cancer is a well-established standard therapy in Japan, and is increasingly used in other countries. The development of endoscopic submucosal dissection (ESD) for early gastric cancer provides en bloc R0 specimen, regardless of size and/or location. On the other hand, for many years, conventional endoscopic mucosal resection and surgery were the only available treatments for large colorectal tumors, including laterally spreading tumors. Recently, ESD has also been increasingly applied to the colon and rectum. However, ESD has not yet been fully established as a standard therapeutic method for colorectal lesions because of its technical difficulty and complications, such as perforation and longer procedure time than the conventional endoscopic mucosal resection. In this report, we provide an overview of the indications for colorectal ESD and presented clinical outcome, regarding the safety and efficacy in our hospital with a review of the published works.