Endoscopic Submucosal Dissection

Introduction Endoscopic submucosal dissection (ESD) was developed in Japan as a treatment for early gastric cancer (EGC). This technique allows en-bloc resection of the lesions [ 1 ] which has demonstrated to be crucial because the local recurrence rate when this is not possible is of 15 % [ 2 ]. Nowadays, there is a huge experience with ESD in Eastern countries where this technique is considered the gold standard treatment for EGC [ 3 ] [ 4 ]. Indications for ESD have expanded to lesions in other locations (esophagus and colon) and other types of lesions (submucosal tumors). However, the introduction of ESD in Europe and the United States of America has been and still is very slow. The aim of this guideline is to familiarize Spanish endoscopists and gastroenterologists not only with the general indications of the procedure and possilble complications but also the dedicated tools.