Author/Authors :
Najib Azmi, Ahmad Department of Medicine - University Malaya Medical Center - Kuala Lumpur, Malaysia , Khor, Christopher J. L Department of Gastroenterology & Hepatology - Singapore General Hospital, Singapore , Ho, Khek-Yu Department of Gastroenterology - National University Hospital, Singapore , Pittayanon, Rapat Department of Medicine - Chulalongkorn University Hospital - Bangkok, Thailand , Rerknimitr, Rungsun Department of Medicine - Chulalongkorn University Hospital - Bangkok, Thailand , Ratanachu-ek, Thawee Department of Surgery - Rajavithi Hospital - Bangkok, Thailand , Koay, Doreen S. C Department of Gastroenterology & Hepatology - Singapore General Hospital, Singapore , Koh, Jianyi Calvin Department of Gastroenterology - National University Hospital, Singapore , Ho, Shiaw-Hooi Department of Medicine - University Malaya Medical Center - Kuala Lumpur, Malaysia , Goh, Khean-Lee Department of Medicine - University Malaya Medical Center - Kuala Lumpur, Malaysia , Mahadeva, Sanjiv Department of Medicine - University Malaya Medical Center - Kuala Lumpur, Malaysia
Abstract :
Endoscopic submucosal dissection (ESD) outcomes have traditionally been reported from high volume
centers in East Asia. Data from low volume centers in other parts of Asia remain sparse. Methods. A retrospective survey with
a structured questionnaire of 5 tertiary centers in 3 countries in South East Asia was conducted. Details of training and clinical
outcomes of ESD cases, with follow-up data from these centers, were analyzed. Results. Seven endoscopists from the 5 centers
performed a total of 35 cases of ESD in the upper gastrointestinal tract (UGIT) over a 6-year duration. Details of the lesions excised
were as follows: median size was 20 mm, morphologically 20 (68.6%) were flat/depressed and 6 (17.1%) were submucosal, and
histologically 27 (77.1%) were neoplastic. The median duration of ESD procedures was 105 minutes, with an Then-bloc resection rate
of 91.4%. There was 1 (2.9%) case of delayed bleeding, but no perforation nor mortality in any of the cases. The recurrence rate after
ESD was 5.7%. A prolonged ESD duration was influenced by a larger size of lesion (25 mm, 𝑝 = 0.02) but not by factors related to
the training experience of endoscopists. Conclusions. ESD in the UGIT is feasible and safe in low volume centers in Asia.
