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

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 follow-up 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 (post-ESD 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 in experienced centers. Future prospective, multicenter studies are warranted to establish standardized ESD practice in Turkiye.