What is Endoscopic submucosal dissection (ESD)?

Endoscopic submucosal dissection (ESD) is a technique developed on the basis of endoscopic mucosal resection (EMR). It can safely remove large lesions completely and in large pieces, and has the characteristics of small trauma, good curative effect, safety and reliability, and comparable to the effect of surgical operation. Endoscopic submucosal dissection (ESD) is mainly applicable to lesions with diameter >20mm, non-granular LST, pit t-pat tern V classification, highly atypical hyperplasia, suspected superficial mucosal infiltration, or lesions that cannot be effectively and completely removed by other endoscopic techniques. ESD can also be used for lesions requiring one-time endoscopic resection, some early cancers, adenomas with negative lift signs, residual EMR >10mm, recurrent and difficult EMR, and low rectal lesions not confirmed as cancer by repeated biopsy. For polyps larger than 2 cm, especially flat polyps, ESD is recommended to remove the lesion completely at one time.

Have serious heart and lung diseases, blood diseases, coagulation function; Negative lesion lifting signs (no obvious local uplift after injection of normal saline at the bottom of the tumor base) suggest that there is adhesion between the submucosa of the base of the lesion and the basic layer, and the tumor may have infiltrated into the muscle layer. Tumor surface with obvious ulcer or scar; Endoscopic ultrasonography indicated that the tumor had infiltrated more than 2/3 of the submucosa. In view of the above conditions, ESD treatment is not advocated.