Endoscopic submucosal dissection: a country dissemination experience and outcomes

Data de publicação: Data Ahead of Print:

Autores da FMUP

  • Diogo Miguel Pereira Libânio Monteiro

    Autor

  • Pedro Filipe Vieira Pimentel Nunes

    Autor

  • Mário Jorge Dinis Ribeiro

    Autor

Participantes de fora da FMUP

  • Rodríguez-Carrasco, M
  • Barreiro, P
  • Ferreira, A
  • Küttner-Magalhaes, R
  • Pinho, R
  • Carvalho, PB
  • Areia, M
  • Lage, J
  • Serrano, M
  • Silva, J
  • Dias-Pereira, A
  • Carvalho, L
  • Cadime, AT
  • Cotter, J
  • Carvalho, J
  • Pedroto, I
  • Gonçalves, R
  • Chagas, C

Unidades de investigação

Abstract

Objective An increasing use of endoscopic submucosal dissection (ESD) has been reported in Western countries, although some differences in training schemes and outcomes have been described. We aimed to report the training model, implementation, and outcomes of ESD in Portugal. Methods All endoscopists trained at our center from our country (n = 9) were invited to a survey regarding: (a) training period; (b) ESD outcomes and (c) implementation of ESD in each respective center. Results All endoscopists completed the survey. Learning ESD was centered on human ESD assistance in a high-volume center during a median time of 6 months and complemented mainly by hands-on courses (89%). During the surveyed period, a total of 1229 ESD were performed, mostly in gastric locations (74%). Median complete R0 and curative resection rate were 92% (IQR, 81-96.8) and 87% (IQR, 74-93.3), respectively, and median perforation rate was 0.89% (IQR, 0.25-6.22). The main limitations encountered during the implementation of ESD were related to the lack of initial mentoring or insufficient expertise to progress to more difficult lesions. Conclusion Learning ESD through participation in hands-on courses and visiting high-volume centers seems to be adequate to achieve a good competence at the initial stage of ESD, which in fact is in consonance with the European Society of Gastrointestinal Endoscopy recommendations. However, mentoring is essential for technical progression, and this represents the fundamental barrier during the adoption of ESD, which may be overcome by increasing hands-on training in animal or artificial simulators, but preferably with the implementation of a structured training program.

Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

Dados da publicação

ISSN/ISSNe:
0954-691X, 1473-5687

EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY  Lippincott Williams and Wilkins Ltd.

Tipo:
Article
Páginas:
1042-1046
Link para outro recurso:
www.scopus.com

Citações Recebidas na Scopus: 2

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Keywords

  • early gastrointestinal tumors; endoscopic resection; endoscopic submucosal dissection; gastrointestinal neoplasms

Proyectos asociados

Individualized gastric adenocarcinoma early diagnosis and improved patients survival: from liquid biopsies to a comprehensive management approach. (IMAGE)

Investigador Principal: Mário Jorge Dinis Ribeiro

Estudo Clínico Académico (IMAGE) . AgênciaD&C . 2021

Effectiveness of endoscopic resection of colonic lesions > 20mm

Investigador Principal: Mário Jorge Dinis Ribeiro

Estudo Clínico Académico (Colonic lesions) . 2020

How endoscopic submucosal dissection for gastrointestinal lesions is being implemented? Results from an international survey

Investigador Principal: Pedro Filipe Vieira Pimentel Nunes

Estudo Clínico Académico (ENDOS) . 2020

Diagnosis and Treatment of Early Gastric Cancer

Investigador Principal: Pedro Filipe Vieira Pimentel Nunes

Estudo Clínico Académico . 2020

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