Management of complications following endoscopic submucosal dissection for gastric cancer.

Endoscopic treatment should be considered for early gastric cancer (EGC) and gastric precancerous lesions. Endoscopic submucosal dissection (ESD) was developed for en bloc removal of a large gastric neoplasm and has been developed following improvements in electrical equipment for hemostasis and dissection and with advances in various knives, hemostatic forceps and endoscopic equipment. ESD is currently the treatment of choice for precancerous lesions or EGC showing mucosal invasion. Hemorrhage and perforation are major complications of ESD for EGC. We describe the complication of ESD procedures in gastric lesions for endoscopists who are relatively inexperienced in ESD and who may lack optimal access to ESD education and facilities.