Marín-Gabriel José Carlos, Fernández-Esparrach Gloria, Díaz-Tasende José, Herreros de Tejada Alberto
José Carlos Marín-Gabriel, José Díaz-Tasende, Department of Gastroenterology, Endoscopy Unit, High Risk GI Cancer Clinic, i+12, Hospital Universitario "12 de Octubre", 28041 Madrid, Spain.
World J Gastrointest Endosc. 2016 Jan 25;8(2):40-55. doi: 10.4253/wjge.v8.i2.40.
Over the last few years, endoscopic submucosal dissection (ESD) has shown to be effective in the management of early colorectal neoplasms, particularly in Asian countries where the technique was born. In the Western world, its implementation has been slow and laborious. In this paper, the indications for ESD, its learning model, the available methods to predict the presence of deep submucosal invasion before the procedure and the published outcomes from Asia and Europe will be reviewed. Since ESD has several limitations in terms of learning achievement in the West, and completion of the procedure for the first cases is difficult in our part of the world, a short review on colorectal assisted ESD has been included. Finally, other endoscopic and surgical treatment modalities that are in competition with colorectal ESD will be summarized.
在过去几年中，内镜黏膜下剥离术（ESD）已被证明在早期结直肠肿瘤的治疗中有效，尤其是在该技术诞生的亚洲国家。在西方世界，其应用进展缓慢且困难重重。本文将对ESD的适应证、学习模式、术前预测深层黏膜下浸润的可用方法以及亚洲和欧洲已发表的治疗结果进行综述。由于ESD在西方的学习成果方面存在若干局限性，且在我们这个地区完成首例手术很困难，因此还纳入了一篇关于结直肠辅助ESD的简短综述。最后，将总结与结直肠ESD竞争的其他内镜和手术治疗方式。
