Endoscopic Submucosal Dissection (ESD): Removing Intestinal Tumors Without Abdominal Surgery
What is ESD?
Endoscopic Submucosal Dissection (ESD) is an advanced minimally invasive procedure used to remove large precancerous tumors or early-stage cancers from the colon or stomach. Using high-precision tools through an endoscope (EGD or Colonoscope), surgeons can remove tumors larger than 2 centimeters in a single piece (en bloc resection). This ensures highly accurate pathological results and optimal treatment planning while allowing patients to avoid major abdominal surgery, eliminate surgical scars, and recover much faster.
Who is ESD Suitable For?
ESD is ideal for patients with precancerous lesions larger than 2 centimeters that cannot be adequately removed by standard methods. Most patients suited for ESD are asymptomatic (showing no symptoms) and are often identified during routine colorectal cancer screenings. This technique is versatile and can be used throughout the digestive tract, including the esophagus, stomach, and small and large intestines. In Thailand, it is most frequently performed for large colon tumors.
Advantages of ESD Treatment
- En Bloc Resection: Removes large tumors (2+ cm) in one single piece for better diagnostic accuracy.
- No External Incisions: The entire procedure is performed through the natural opening using an endoscope.
- Surgical Avoidance: Helps patients avoid traditional open or laparoscopic abdominal surgery.
- Rapid Recovery: Minimal downtime; in some specific cases, it may even be performed as an outpatient (OPD) case.
Precautions and Considerations
- Expertise Required: This procedure is technically demanding and must be performed by highly specialized endoscopists with significant experience and precision.
- Risk of Perforation: There is a small risk of intestinal perforation (approximately 5%), which is carefully managed by the surgical team.
