Therapeutics Advances
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Jan 25, 2016; 8(2): 40-55
Published online Jan 25, 2016. doi: 10.4253/wjge.v8.i2.40
Colorectal endoscopic submucosal dissection from a Western perspective: Today’s promises and future challenges
José Carlos Marín-Gabriel, Gloria Fernández-Esparrach, José Díaz-Tasende, Alberto Herreros de Tejada
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
Gloria Fernández-Esparrach, Department of Gastroenterology, Endoscopy Unit, CIBEREHD, IDIBAPS, Hospital Clínic, Universidad de Barcelona, 08036 Barcelona, Spain
Alberto Herreros de Tejada, Department of Gastroenterology, IDIPHIM, Hospital Universitario Puerta de Hierro, Majadahonda, 28222 Madrid, Spain
Author contributions: Marín-Gabriel JC and Fernández-Esparrach G designed and coordinated this review; Marín-Gabriel JC, Díaz-Tasende J and Herreros de Tejada A contributed to the writing of the manuscript and revised it before submission; Fernández-Esparrach G gave final approval of the version to be submitted and the revised version.
Conflict-of-interest statement: The authors report no conflicts of interest regarding the content of this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: José Carlos Marín-Gabriel, MD, PhD, Department of Gastroenterology, Endoscopy Unit, High Risk GI Cancer Clinic, i+12, Hospital Universitario “12 de Octubre”, Avda. Andalucía s/n, 28041 Madrid, Spain. josecarlos.marin@salud.madrid.org
Telephone: +34-91-7792827 Fax: +34-91-7792957
Received: June 29, 2015
Peer-review started: June 30, 2015
First decision: August 25, 2015
Revised: November 1, 2015
Accepted: November 24, 2015
Article in press: November 25, 2015
Published online: January 25, 2016
Abstract

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.

Keywords: Endoscopic submucosal dissection, Endoscopic full-thickness resection, Endoscopic mucosal resection, Hybrid endoscopic submucosal dissection, Early colorectal cancer, Assisted endoscopic submucosal dissection, Magnification chromoendoscopy, Colorectal surgery, Colorectal neoplasm, Submucosal invasion, Predictive factors, Training, Learning curve

Core tip: In the Western world, endoscopic submucosal dissection (ESD) implementation is 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. Additionally, 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.