Endoscopic submucosal dissection: can it safely expand indications for a minimally invasive approach to patients with early gastric cancer?

摘要

In contrast to Western countries, Asian countries such as Japan and Korea diagnose gastric cancers at an early stage, confronting the disease with screening programs and perhaps a different cancer biology. This early detection allows a minimally invasive treatment approach, substantially improving quality of life (QOL) for patients with early gastric cancer (EGC).In these Asian countries, conventional open gastrectomy and minimally invasive interventions including endoscopic mucosal resection (EMR) and laparoscopic gastrectomy have been established as standard treatment when specific criteria are met. For example, EMR is recommended by Japanese guidelines for small tumors confined to the mucosal layer of the intestinal type [1].