Clinical Application of Endoscopic Submucosal Dissection in Malignant Gastrointestinal Tumors and Precursors

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Gastroenterology & Hepatopancreatobiliary Medicine".

Deadline for manuscript submissions: 20 September 2024 | Viewed by 337

Special Issue Editors


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Guest Editor
Department of Gastroenterology, Ordensklinikum Linz Barmherzige Schwestern, 4010 Linz, Austria
Interests: endoscopy; hepatology; gastroenterology; inflammatory bowel disease; biliary tract diseases; liver diseases

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Guest Editor
Department of General, Visceral, Thoracic and Transplant Surgery, Ordensklinikum Linz, 4010 Linz, Austria
Interests: surgical oncology; pancreas, liver; bile; upper GI; surgical infection
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Special Issue Information

Dear Colleagues,

Advanced healthcare systems support systematic screening programs for the diagnosis of premalignant and early malignant lesions. To ensure maximum benefit for patients, these findings should be treated using minimally invasive techniques. This not only improves prognosis but also contributes to anatomical and functional organ preservation.

Within the gastrointestinal tract, the most advanced endoscopic technique for achieving these goals is endoscopic submucosal dissection (ESD). It competes with endoscopic mucosal resection and snare polypectomy, as well as hybrids with other endoscopic interventions and laparoscopic surgical access. Depending on the results of pretherapeutic staging, more invasive options, such as surgical resection, radiation, or systemic medical therapies, might represent the preferred choice. This underscores the critical importance of the staging process.

In this Special Issue, we are gathering original data on advanced endoscopic imaging and staging, along with the application of ESD in the esophagus, stomach, duodenum, and colorectum. Reviews on ESD, highlighting its advantages and drawbacks within the therapeutic network, will complement this virtual collection of articles.

We warmly invite researchers to contribute to our project, and we encourage readers to benefit from the insights shared in this collection.

Prof. Dr. Rainer Schöfl
Prof. Dr. Reinhold Függer
Guest Editors

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Keywords

  • endoscopy
  • endoscopic submucosal dissection
  • endoscopic surgery
  • laparoscopic surgery
  • minimally invasive surgery

Published Papers (1 paper)

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Research

10 pages, 1839 KiB  
Article
Retrospective Analysis of Rectal Endoscopic Submucosal Dissection at Ordensklinikum Linz and Kepler Universitätsklinikum Linz
by Nikolaj Swiridoff, Alexander Ziachehabi, Friedrich Wewalka, Georg Spaun, Vedat Alibegovic and Rainer Schöfl
J. Clin. Med. 2024, 13(12), 3530; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm13123530 - 17 Jun 2024
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Abstract
Background and study aim: Endoscopic submucosal dissection is a minimally invasive endoscopic procedure for the removal of neoplastic benign and early malignant lesions in the gastrointestinal tract. In this study, we analyse the success and safety of rectal ESD at Linz hospitals, [...] Read more.
Background and study aim: Endoscopic submucosal dissection is a minimally invasive endoscopic procedure for the removal of neoplastic benign and early malignant lesions in the gastrointestinal tract. In this study, we analyse the success and safety of rectal ESD at Linz hospitals, focusing on a specific endoscopist. Additionally, we examine whether there is a learning curve regarding success parameters. Methods: This retrospective study included all 102 patients who underwent endoscopic submucosal dissection of the rectum by a defined endoscopist at Ordensklinikum Hospital and Kepler University Hospital between December 2010 and May 2021. With the collected data, a descriptive statistic was carried out and regression analyses were performed. Results: The en bloc resection rate was 78.4% and the rate of lesions removed in healthy tissue was 55.6%. The average procedure time was 179 min and the complication rate was 7.8%. In total, 26.4% of cases showed carcinoma; in 25.9% of these cases, an oncologically curative resection was achieved with ESD. Follow-up data were available for 61.1% of cases, with recurrence being diagnosed in 3.6% of cases. A learning curve was observed regarding the rate of lesions removed in healthy tissue and the procedure time, but not regarding the en bloc resection rate. Conclusions: Endoscopic submucosal dissection is a safe method for the removal of large rectal adenomas and early carcinomas. The en bloc resection rate of the analysed procedures is within the range of comparable European studies. The rate of lesions removed in healthy tissue is below the R0 resection rate of the comparative literature; however, a learning curve could be observed in this parameter. Full article
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