Mapping Two Decades of Research on Endoscopic Submucosal Dissection in Esophageal Cancer: A Bibliometric and Visual Analysis.

BACKGROUND Endoscopic submucosal dissection (ESD) is established as a key minimally invasive, function-preserving technique for early-stage esophageal cancer, valued for its high rate of en bloc resection. This study aims to provide a comprehensive bibliometric and visual analysis of research on ESD in esophageal cancer from 2006 to 2025. MATERIAL AND METHODS A systematic literature search was performed in the Web of Science Core Collection. Bibliometric analysis and visualization were conducted using VOSviewer, CiteSpace, and the R package "bibliometrix". RESULTS A total of 512 original research articles were included in the analysis. Japan and China collectively contributed over 82% of the total output, with Japanese institutions and authors dominating in productivity and citation impact. Keyword co-occurrence analysis identified 5 thematic clusters: (1) post-ESD complication management; (2) early diagnosis and risk lesion detection; (3) survival analysis and prognostic indicators; (4) adjunctive and supportive therapies; and (5) endoscopic technique and visualization. Recent keyword bursts since 2020 highlighted emerging priorities including "risk factors", "early esophageal cancer", and "prevention". CONCLUSIONS This bibliometric analysis reveals a clear research trajectory in ESD for esophageal cancer, shifting from foundational technique refinement toward multimodal and personalized management strategies. These findings provide a structured reference for identifying research priorities, fostering international collaboration, and guiding future investigations in this field.