Endoscopic submucosal dissection (ESD) has been established as a standard treatment for early stage gastric cancer (EGC) in Japan and has spread worldwide. ESD has been used not only for EGC but also for early esophag...Endoscopic submucosal dissection (ESD) has been established as a standard treatment for early stage gastric cancer (EGC) in Japan and has spread worldwide. ESD has been used not only for EGC but also for early esophageal and colonic cancers. However, ESD is as-sociated with several adverse events, such as bleeding and perforation, which requires more skill. Adequate tissue tension and clear visibility of the tissue to be dissected are important for effective and safe dissection. Many ESD methods using traction have been devel-oped, such as clip-with-line method, percutaneous trac-tion method, sinker-assisted method, magnetic anchor method, external forceps method, internal-traction method, double-channel-scope method, outerroute method, double-scope method, endoscopic-surgical-platform, and robot-assisted method. Each method has both advantages and disadvantages. Robotic endos-copy, enabling ESD with a traction method, will become more common due to advances in technology. In thenear future, simple, noninvasive, and effective ESD us-ing traction is expected to be developed and become established as a worldwide standard treatment for superficial gastrointestinal neoplasias.展开更多
文摘Endoscopic submucosal dissection (ESD) has been established as a standard treatment for early stage gastric cancer (EGC) in Japan and has spread worldwide. ESD has been used not only for EGC but also for early esophageal and colonic cancers. However, ESD is as-sociated with several adverse events, such as bleeding and perforation, which requires more skill. Adequate tissue tension and clear visibility of the tissue to be dissected are important for effective and safe dissection. Many ESD methods using traction have been devel-oped, such as clip-with-line method, percutaneous trac-tion method, sinker-assisted method, magnetic anchor method, external forceps method, internal-traction method, double-channel-scope method, outerroute method, double-scope method, endoscopic-surgical-platform, and robot-assisted method. Each method has both advantages and disadvantages. Robotic endos-copy, enabling ESD with a traction method, will become more common due to advances in technology. In thenear future, simple, noninvasive, and effective ESD us-ing traction is expected to be developed and become established as a worldwide standard treatment for superficial gastrointestinal neoplasias.
