Learning curve in esophageal endoscopic submucosal dissection by Western endoscospists trained in Japan: experience in Latin America

Aliaga Ramos J.; Yoshida N.; Abdul Rani R.; Arantes V.N. · Arquivos de Gastroenterologia (2023) · DOI: 10.1590/s0004-2803.20230222-168

Resumen

Background – Esophageal endoscopic submucosal dissection (EESD) is a complex and time-consuming procedure at which training are mainly available in Japan. There is a paucity of data concerning the learning curve to master EESD by Western endoscopists. Objective – This study aimed to assess the learning curve effect on patient’s clinical outcome for EESD. Methods – This is a retrospective observational study. Enrolling patients that underwent EESD from 2009 to 2021. The analysis was divided into two periods; T1: case 1 to 49 and T2: case 50 to 98. The following features were analyzed for each group: patients and tumors characteristics, en-bloc, complete and curative resection rates, procedure duration and adverse events rate. Results – Ninety-eight EESD procedures were performed. Mean procedure time was 111.8 min and 103.6 min for T1 and T2, respectively (P=0.004). En bloc resection rate was 93.8% and 97.9% for T1 and T2, respectively (P=0.307). Complete resection rate was 79.5% and 85.7% for T1 and T2, respectively (P=0.424). Curative resection rate was 65.3% and 71.4% for T1 and T2, respectively (P=0.258). Four patients had complications; three during T1 period and one during T2 period. Overall mortality rate: 0%. Conclusion – The esophageal endoscopic submucosal dissection could be performed effectively and safely by an adequately trained Western endoscopist.