Endoscopic submucosal dissection (ESD) is a minimally invasive procedure that removes pre-cancerous or cancerous tumors of the GI (gastrointestinal) tract. Your provider uses a thin, flexible tube with a camera on the end (endoscope) to identify polyps or tumors and insert tools through the tube to remove them.
ESD is an advanced procedure that requires exceptional skill and precision. It is performed by GI doctors (gastroenterologists) with specialized training in the procedure. 黑料网 is one of few health centers in San Antonio to offer it.
What is endoscopic submucosal dissection?
ESD is typically used for tumors between the muscle wall and the linings of internal organs. They are usually large (over 2 cm), have unclear borders and are located too close to muscle tissue, making them hard to remove by other methods.
With ESD, our fellowship-trained advanced endoscopists can remove an entire tumor in one piece. This lowers the risk of leaving cancer cells behind, making it highly likely that you have a full recovery. ESD can also help doctors determine what stage the GI cancer is in and where it has spread.
For smaller tumors, endoscopic mucosal resection (EMR) is another method of removal. With EMR, doctors remove smaller sections of the tumor piece by piece. While EMR is less risky and a shorter procedure, ESD has better outcomes for large tumors. It allows for more accurate staging and has lower recurrence rates.
Why choose us for endoscopic submucosal dissection
There are many reasons to trust 黑料网 with your care, including:
- Academic and research excellence: 黑料网 is an academic health center, which includes medical research and training the next generation of doctors. This means we study and use innovative technology and emerging treatments and techniques. Integrating academic research with our team of subspecialty-trained experts leads to consistently better patient outcomes.
- Cohesive multidisciplinary team: Our advanced endoscopists are a part of one of the largest GI programs in the region. They collaborate with gastroenterologists, oncologists and radiation oncologists at Mays Cancer Center, home to 黑料网 MD Anderson Cancer Center. They also work across disciplines with pathologists, radiologists and other specialists to ensure you receive seamless, comprehensive care.
- Regional expertise: Our advanced endoscopists are board-certified and fellowship and subspecialty trained to treat everything from routine to complex cases. They are also nationally and internationally recognized in their field.
- State-of-the-art technology: Our doctors use the latest endoscopic technology at the 黑料网 Multidisciplinary and Research Hospital. This includes advanced endoscopes with the highest zoom technology available. They also use AI-powered technology to detect polyps that might otherwise go undetected.
What to expect with endoscopic submucosal dissection
ESD is usually an outpatient procedure, so you may go home the same day. You can expect it to take about one to three hours.
The GI doctor will place the endoscope either through your mouth or anus, depending on where the tumor is located. The procedure requires no incisions, which means you may have less pain and a quicker recovery.
Frequently asked questions about endoscopic submucosal dissection
What does endoscopic submucosal dissection treat?
ESD can be used for some types of:
- Barrett鈥檚 esophagus at risk of causing cancer
- Colon polyps
- Small intestine cancer
How do I prepare for endoscopic submucosal dissection?
Preparation for your ESD treatment depends on whether the GI doctor will be treating your upper GI tract (including the esophagus, small intestine or stomach) or lower GI tract (including the colon, large intestine and rectum).
Treatment of the upper GI tract requires not eating or drinking for 12 hours before your procedure. If the tumor is in your lower GI tract, you may need to follow a liquid diet and take laxatives before your procedure.
What happens during and after endoscopic submucosal dissection?
You will be under anesthesia and be comfortable throughout the procedure. Once you are sedated, your GI doctor will:
- Insert the endoscope and route it to the location of the tumor. They will mark its exact location.
- Inject a liquid solution that helps separate the tumor from surrounding tissue. This makes it easier to access.
- Use a surgical instrument with a high-frequency electrical current to remove the tumor.
- Send the tumor to a lab for a pathology exam, which shows whether cancer is present.
After your procedure, you may go home the same day or remain in the hospital for up to 24 hours after your procedure. A friend or family member needs to be at the hospital to drive you home because you may be groggy afterwards.
What are the risks and side effects of endoscopic submucosal dissection?
There may be minor side effects after your procedure, such as:
- Bloating, cramping or gas pain
- Sore throat
- Stomachache or vomiting
You may also notice some blood in your stool for 24 hours following your ESD procedure. Contact your doctor immediately if it lasts any longer.
Possible complications from ESD are uncommon. Rarely, people experience bleeding, GI perforation or scarring.
What is the success rate of endoscopic submucosal dissection?
ESD is considered a highly successful procedure. Five-year recurrence rates ranged from roughly 1-2% based on a recent study listed in the National Library of Medicine.
Contact Us
ESD requires a physician鈥檚 referral. Call 210-450-9880 to make an appointment with one of our specialists to see if you are eligible.