Endoscopic Submucosal Dissection in France Inferior to That in Japan

Endoscopic submucosal dissection (ESD) was developed in Japan for the treatment of patients with early gastric cancers. Many reports from Asia have now described its successful use for both gastric and colorectal tumors, but the technique is still seldom used in the West. Compared with endoscopic mucosal resection, ESD provides a greater chance of R0 resection (resection with clear deep and lateral margins), a higher rate of cure at first follow-up, and superior specimens for histologic assessment. In Japan, the perforation rate of ESD is about 5%, but most perforations are closed with endoscopic clips. After undergoing ESD in Japan, patients are typically observed in the hospital for several days to a week.

Now, 22 gastroenterologists from …