Endoscopic Resection of Early Gastric Cancer
Early gastric cancer carries an excellent survival rate when treated endoscopically. The challenge is choosing the right resection technique. Endoscopic mucosal resection (EMR) achieves R0 in only about 73% of cases. Endoscopic submucosal dissection (ESD) pushes that number to 88% curative resection, even for lesions larger than 40 mm. In this lecture, Klaus walks through the core principles that make ESD the preferred approach.
Why EMR Falls Short
EMR was the first-generation approach to endoscopic resection of early gastric cancer. It works by snaring superficial tissue after lifting the mucosa with submucosal injection. The problem: piecemeal resection is common, and complete removal is not always possible. Miyata and colleagues from Japan demonstrated years ago that EMR achieved complete resection in only about 73% of patients. That gap leaves behind residual cancer tissue that may require surgery.
ESD solves this by dissecting beneath the lesion in one piece. It enables en bloc, oncological resection regardless of lesion size and morphology.
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Get access to the full ESD technique walkthrough, knife selection guidance, and outcomes data from 952 patients, plus the full video with English captions.
What you'll learn
- ESD knife selection and setup
- Step-by-step submucosal dissection technique
- Outcomes data from 952 patients
- Full video with English captions
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