Precision Treatment for Early-Stage Gastrointestinal Lesions

What is Endoscopic Submucosal Dissection (ESD)?

Endoscopic Submucosal Dissection (ESD) is an advanced, minimally invasive endoscopic procedure used to remove large, complex, or early-stage cancerous lesions from the gastrointestinal (GI) tract, including the esophagus, stomach, and colon. Unlike standard polypectomy or EMR (Endoscopic Mucosal Resection), ESD allows for the removal of deeper and larger lesions in a single piece, ensuring more precise results and thorough treatment.

At Central Gastro, we specialize in ESD to offer safe, effective, and surgery-free solutions for early GI cancers and complex polyps.

Why is Endoscopic Submucosal Dissection Performed?

ESD is performed to treat:

• Early-Stage GI Cancers (esophagus, stomach, or colon) confined to the mucosa and submucosal layer.
• Large or Flat Polyps that cannot be removed using standard polypectomy or EMR techniques.
• Precancerous Lesions that require complete removal to prevent cancer progression.
• Suspicious Lesions detected during routine screening endoscopy or colonoscopy.

By enabling en-bloc (single-piece) resection, ESD reduces the risk of recurrence and ensures precise histopathological evaluation.

How is Endoscopic Submucosal Dissection Performed?

The ESD procedure is performed under sedation or general anesthesia for your comfort. It involves several key steps:

1. Preparation
   • Upper GI ESD: Fasting for 6–8 hours before the procedure.
   • Colonic ESD: Bowel preparation (cleansing) to ensure a clear view.
2. Procedure
   • A flexible, thin tube with a camera (endoscope) is inserted through the mouth (for upper GI lesions) or rectum (for colonic lesions).
   • The lesion is carefully marked to define the area to be removed.
   • A lifting solution is injected beneath the lesion to separate it from the deeper layers of the GI wall.
   • Specialized instruments are used to precisely dissect the lesion along the submucosal layer while preserving surrounding healthy tissue.
   • The lesion is removed in one piece (en-bloc), allowing detailed pathological analysis.
3. Recovery
   • The procedure typically takes 1–3 hours, depending on the size and location of the lesion.
   • After the procedure, you will be monitored in recovery and can usually return home the same day or the next morning.

Benefits of Endoscopic Submucosal Dissection (ESD)

• Minimally Invasive: Avoids open surgery, reducing risks and recovery time.
• En-Bloc Resection: Removes lesions in a single piece for more accurate analysis and reduced recurrence risk.
• Preserves GI Function: Allows complete removal of lesions without removing sections of the GI tract.
• Early Cancer Cure: Offers a curative option for early-stage GI cancers.
• Faster Recovery: Shorter recovery time compared to traditional surgery.

Who is a Candidate for ESD?

ESD is ideal for patients with:

• Early-stage esophageal, gastric, or colonic cancers confined to the inner layers of the GI tract.
• Large or complex polyps that cannot be removed via polypectomy or EMR.
• Suspicious lesions detected during screening colonoscopy or endoscopy.

Our team at Central Gastro will conduct a thorough evaluation to determine if ESD is the most appropriate treatment option for you.

What to Expect After the Procedure

• Dietary Restrictions: You may need to follow a liquid or soft diet for a few days.
• Monitoring: Mild discomfort is common, but you will be closely monitored for any complications.
• Follow-Up: A follow-up endoscopy will be scheduled to ensure proper healing and confirm no remaining abnormal tissue.
• Ongoing Surveillance: Regular screenings may be recommended to monitor for recurrence, depending on your diagnosis.