ArticleiGIE : innovation, investigation and insights2023
Implementation of endoscopic submucosal dissection in Europe: survey after 10 ESD Expert Training Workshops, 2009 to 2018.
Article in iGIE : innovation, investigation and insights, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
3 citing papers in PubMed.
- Review
- Clinical Endoscopic Submucosal Dissection of Trainees Tutored by Experts-ESGE Endorsed Courses and Live Endoscopic Events 2011-2015.Journal of clinical medicine · 2026Article
- Endoscopic Resection Techniques for Widespread Precancerous Lesions and Early Carcinomas in the Rectum.Journal of clinical medicine · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
20 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background and Aims: Adoption of the endoscopic submucosal dissection (ESD) technique for early GI cancer from Japan requires expert-supervised experimental training before unsupervised implementation of clinical ESD. The aim of this study was to evaluate unsupervised implementation of ESD intention-to-treat (ie, any resection planned and started as en bloc ESD). Methods: ESD workshops (in vivo porcine model) lasted 3.3 days, including a 1-day theory seminar, for 177 participants from 135 Western referral centers. A questionnaire was sent to the senior participant of all 135 centers. This cross-sectional questionnaire survey included main outcome measurements such as performance, organ distribution, and severe adverse events of ESD intention-to-treat. Results: Feedback was received from 113 centers (84%): 73 (54%) ESD centers and 40 centers (30%) with zero ESDs. Ten (7%) had published ESDs; no feedback was received from 12 (9%) centers with unknown status. Altogether, 83 centers (61.5%) performed ESDs: 21 (16%) had >150 ESDs (professional category), 33 (24%) had 31 to 150 ESDs (competent category), and 29 (21.5%) had ≤30 ESDs (initial learning category). Most implemented ESD centers (91% [72 of 79]) were analyzed: centers on initial learning (420 ESD) compared with centers with >30 ESDs (5676 ESDs) performed en bloc ESDs in 64% versus 84%, hybrid ESD in 26% versus 11%, and piecemeal EMR in 10% versus 5.2%. The majority of ESDs (66%-68%) performed were in the colorectum, with a low risk overall (30-day mortality, 0.03%; surgical repair, 3.5% vs 1.7%) and satisfactory outcome (oncosurgery, 7.4% vs 5.2%; local recurrence, 1.5% vs 0.3%). Conclusions: Beyond guideline recommendations, unsupervised implementation of ESD was successful in the colorectum with a step-up approach. Western ESD centers must now aim for professional (ie, >80%) curative ESD.
Identifiers
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.