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Endoscopic Submucosal Dissection

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Endoscopic Submucosal Dissection
Introduction

Endoscopy is a procedure that enables the medical professions to examine or even treat the hollow organs or cavities of a body.

What is Endoscopic Submucosal dissection?

This is a medical procedure used to alternate the surgical removal of the tumours from the gastrointestinal tract in a human body. The design was invented at the beginning of the 2000s and was initially used to remove cancerous cells or tumours from the inner lining of the food pipe. It is also used in conditions where parts of the stomach or colon need to be treated to remove the tumours without breakage. The technique includes injecting a coloured fluid into the damaged area, slowly inserting the endoscope, and finally removing the diseased tissue.

Surgical removal or ESD?

Before the technique was introduced, surgeries were the only options. Still, with the introduction of ESD, it has been getting popular among patients and medical professionals because of the ease and low risk involved in the procedure as a Stomach cancer treatment and treatment also for cancer in the oesophagus. It has also been undergoing various advancements, which has led to even more popularity. Some of the progress is as follows:

  1. It has always been a challenge for professionals to demarcate the edges of the lesions. But, with the introduction of chromoendoscopy, this task has been made much more manageable.
  2. With the introduction of electrosurgical knives, the procedure has become not only safe but more straightforward too.
  3. Advancements in suturing techniques have also made the procedure safe to be performed.
What are the uses of ESD?

Primarily, the procedure is used to treat malignant or even premalignant conditions that tend to affect the inner lining of the gastrointestinal tract. Areas that your doctor can treat through ESD for the removal of tumours include:

  • a__ Stomach
  • a__ Rectum
  • a__Oesophagus
What are oesophagal and gastric cancers?

Gastric and oesophageal cancers are those tumours that originate through a series of changes that take place in the cells. The changes are, however, uncontrolled and tend to cause stomach cancer or oesophageal cancer. ESD is one of the safest and the most advanced techniques being used for the removal of such tumours.

Various Stomach cancer causes have been known to act as a catalyst in the spread of the disease

  1. Obesity
  2. Smoking
  3. Family history
  4. Nutritional deficiencies
What does the procedure involve?
  1. Anaesthesia: This is the first and the foremost step involved in ESD. The doctor prepares the patient with an appropriate dose of anaesthesia.
  2. Endoscope insertion: The device or the endoscope is then passed through the hollow organ that he is looking to examine or treat. It is inserted either through the mouth or through the rectum depending upon the position of the tumour in the body.
  3. Injection: The are supposed to be treated are then injected with a coloured fluid to differentiate from the healthy ones.
  4. Removal: The diseased tissue or the tumour is then removed with the help of the endoscopic knife.
What are the complications of ESD?

It is essential to consider that all surgical procedures have some degree of risk involved. ESD is comparatively a very safe and risk-free procedure. But a shallow degree of risk can include perforation or bleed from the body parts being treated.

What are the advantages of ESD for oesophageal and gastric cancers?

Here are some of the advantages of the ESD technique for the removal of diseased tissue in individuals where Gastric cancer causes high discomfort but are in the beginning stages :

  1. The procedure allows the medical professional to remove the entire tumour in a single piece without any breakage, ensuring that the broken pieces or the remaining parts do not grow into cancer again.
  2. The organ from where the tumour has to be removed stays intact, ensuring the patient leads a normal and healthy lifestyle.
  3. The technique also helps the surgeon examine if cancer has spread to other surrounding tissues of the organ.
  4. ESD has the potential for Gastric cancer treatment at early stages. As long as cancer has not spread to the other parts of the body, the treatment is very effective.
  5. According to a study, cancer treated by the ESD technique has lesser recurrence rates of the tumours compared to the other methods.
What are the side effects of ESD?

Here are the side effects of the ESD procedure for treating cancer:

  1. Excessive bleeding
  2. Tear or perforation
  3. Narrowing of the part being treated.
  4. Although these side effects can be seen in a few cases but do not pose a risk to the patients’ lives.
Prognosis of the disease after ESD procedure

Prognosis refers to the chance of recovery or the recurrence of the disease. Because the procedure is relatively safe and does not

involve risk to either the internal organ being treated or the health of the patient, on the whole, the prognosis it tends to bring is excellent.

Conclusion

ESD has certainly proved to be a very useful procedure for removing the stomach or gastrointestinal tract tumour. The fact that it is safe, quick, and does not involve any surgery to be performed has made it very popular among doctors and patients.