Endoscopic submucosal dissection for the treatment of gastrointestinal neoplasia in a tertiary-care center in Mexico.

Abstract

Objective: The aim of this study was to evaluate the experience of using endoscopic submucosal dissection (ESD), a technique considered as first-line of treatment, for the management of early neoplastic lesions (ENL), and subepithelial lesions (SEL) < 4 cms in size, in a tertiary-care, high-volume medical center in Mexico.

Method: Patients > 18 years-old, candidates to ESD with ENL and SMT, between January 2008 and October 2022 were included.

Results: ESD was performed in 246 patients (137 ENL and 109 SMT), 52.2% gastric, 23.1% colonic, 19.5% esophageal and 5.2% in duodenum. Benign/premalignant were 74.4%, and 25.6% malignant, being the SMT the most frequent (44.3%) and gastrointestinal stromal tumor. En-bloc resection, R0, and curative resection rates were 97.2%, 94.5%, and 85.8%, respectively. The most common adverse event was transprocedural bleeding (18.3%) followed by perforation (6.9%), both endoscopically treated without mortality. Recurrence was presented in 9.44% at 177 months of follow-up.

Conclusions: ESD is a safe and effective endoscopic surgical option of treatment for ENL and SMT in Mexican population when performed in experienced centers.