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Canadian Journal of Gastroenterology
Volume 27, Issue 12, Pages 689-693
http://dx.doi.org/10.1155/2013/536190
Review

Endoscopic Submucosal Dissection in the Colorectum: Feasibility in the Canadian Setting

Marietta Iacucci,1 Gregory Eustace,1 Toshio Uraoka,2 Yutaka Saito,3 Miriam Fort Gasia,1 Jon Love,1 and Naohisa Yahagi2

1Division of Gastroenterology & Hepatology, Endoscopy Unit University of Calgary, Calgary, Alberta, Canada
2Division of Research and Development of Minor Invasive Treatment, Cancer Center, School of Medicine, Keio University, Japan
3Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan

Received 15 September 2013; Accepted 16 September 2013

Copyright © 2013 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Endoscopic submucosal dissection is a minimally invasive endoscopic technique for the removal of gastrointestinal tumours that is increasingly being used for colonic neoplasms to spare resection of colon in selected patients. Colonic endoscopic submucosal dissection is technically challenging and was initially pioneered in Japan but increasingly used in selected western centres. Its use in Canada is currently limited, and the authors review the challenges and opportunities, in addition to the unique training infrastructure required to practice the procedure under supervision. Specific tools are required to perform endoscopic submucosal dissection and meticulous attention to detail is essential. The authors provide a combined Japanese and Canadian perspective to this technique, and discuss training and performance of endoscopic submucosal dissection as well as potential indications.