LEARNING CURVE IN ESOPHAGEAL ENDOSCOPIC SUBMUCOSAL DISSECTION BY WESTERN ENDOSCOSPISTS TRAINED IN JAPAN: EXPERIENCE IN LATIN AMERICA

Abstract

•This study aimed to assess the learning curve effect on patient's clinical outcome for EESD. Retrospective observational study, enrolling patients that underwent EESD from 2009 to 2021, divided in 2 groups. Mean procedure time was 111.8 min and 103.6 min for T1 and T2, respectively (P=0.004). The learning curve in esophageal ESD could be overcomed effectively and safely by an adequately trained Western endoscopist. 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.