Endoscopic submucosal dissection in gastrointestinal lesions - Clinical outcomes from a single center

Sep 23, 2026

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Endoscopic submucosal dissection (ESD) is increasingly used for en bloc resection of superficial gastrointestinal neoplasms, enabling accurate histopathology and potentially curative treatment. Clinical evidence from Turkiye has been limited, so this retrospective study analyzed 147 patients treated between January 2020 and January 2025 at a tertiary center. Outcomes included technical success, complications, histopathology, and local recurrence during follow-up. En bloc resection reached 99.3% with R0 in 93.9%. Complications occurred in 3.4% intra-procedurally and 4.7% post-procedurally, managed conservatively, with rare recurrence.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages9

Reading Time23 min

AccessFree to download

Abstract

Objective

Methods

Results

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Rationale for ESD

Comparison with EMR

Factors affecting outcomes

Orıgınal Article GASTROENTEROLOGY North Clin Istanb 2026;13(1):19–27 doi: 10. 14744/nci.2025.37108 Endoscopic submucosal dissection in gastrointestinal lesions: Clinical outcomes from a single center Huseyin Aykut,1 Emin Pala,2 Suleyman Sayar,3 Oguzhan Ozturk,4 Resul Kahraman,5 Kamil Ozdil6 1Department of Gastroenterology, University of Health Sciences, Umraniye Training and Research Hospital, Istanbul, Turkiye 2Department of Gastroenterology, Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, Istanbul, Turkiye 3Department of Gastroenterology, VM Medical Park Pendik Hospital, Istanbul, Turkiye 4Department of Gastroenterology, Biruni University Faculty of Medicine Hospital, Istanbul, Turkiye 5Department of Gastroenterology, Demiroglu Bilim University Faculty of Medicine, Istanbul, Turkiye 6Department of Gastroenterology, Memorial Atasehir Hospital, Istanbul, Turkiye ABSTRACT OBJECTIVE: Endoscopic Submucosal Dissection (ESD) is increasingly utilized for en bloc resection of superficial gastrointestinal neoplasms, providing accurate histopathological evaluation and potential curative treatment. Despite its widespread use in Eastern Asia, clinical data from Turkiye remain limited. In this study, we aimed to retrospectively analyze clinical parameters such as technical success, complication rates, histopathological findings and local recurrence rates observed during follow-up in ESD procedures performed at our center. METHODS: We retrospectively analyzed 147 patients who underwent ESD or hybrid ESD at a tertiary center between January 2020 and January 2025. Demographic characteristics, lesion features, procedural outcomes, complications, and followup results were evaluated. RESULTS: En bloc resection was achieved in 99.3% of cases, with R0 resection in 93.9% . Invasive adenocarcinoma was detected in 7 patients; 3 patients with invasive adenocarcinoma and 1 patient with incomplete resection were referred for surgery. Intra-procedural complications (mainly bleeding) occurred in 3.4%, while post-procedural complications (postESD coagulation syndrome or microperforation) occurred in 4.7% . All complications were managed conservatively, and none required surgery. Median hospital stay was 1 day. Recurrence was rare and successfully managed either endoscopically or surgically. CONCLUSION: ESD is a safe and effective treatment for superficial gastrointestinal neoplasms in appropriately selected patients when performed by an experienced team. High technical success and low complication rates can be achieved inexperienced centers. Future prospective, multicenter studies are warranted to establish standardized ESD practice in Turkiye. Keywords: En bloc resection; endoscopic submucosal dissection; endoscopy; superficial gastrointestinal neoplasms; Turkiye. Cite this article as: Aykut H, Pala E, Sayar S, Ozturk O, Kahraman R, Ozdil K. Endoscopic submucosal dissection in gastrointestinal lesions: Clinical outcomes from a single center. North Clin Istanb 2026;13(1):19–27. Endoscopic important plastic lesions treatment methods are becoming more in the management of superficial neoin the gastrointestinal tract [1]. Among these approaches, Endoscopic Submucosal Dissection (ESD) stands out for enabling en bloc resection of earlystage malignancies, particularly in the stomach, esoph- Received: November 17, 2025 Accepted: December 22, 2025 Online: February 11, 2026 Correspondence: Huseyin AYKUT, MD. Umraniye Egitim ve Arastirma Hastanesi, Saglik Bilimleri Universitesi, Gastroenteroloji Klinigi, Istanbul, Turkiye. Tel: +90 505 631 09 18 e-mail: [huseyin.ayk@gmail.com](huseyin.ayk@gmail.com) Istanbul Provincial Directorate of Health-Available online [at www.northclinist.com](at www.northclinist.com) agus, and colorectal regions, optimizing histopathological staging, and offering potentially curative treatment [2–4]. Initially developed in Japan for the treatment of early gastric c

FAQs

What was the study objective regarding ESD in Turkiye?

To retrospectively analyze clinical parameters including technical success, complication rates, histopathological findings, and local recurrence after ESD performed at a single center in Turkiye.

What were the main effectiveness outcomes reported?

En bloc resection was achieved in 99.3% of cases, and R0 resection was reported in 93.9%.

How often did complications occur and how were they managed?

Intra-procedural complications occurred in 3.4% (mainly bleeding) and post-procedural complications in 4.7% (postESD coagulation syndrome or microperforation). All were managed conservatively, and none required surgery.

Sep 23, 2026

Uploaded by Callum