Endoscopic submucosal dissection for early gastrointestinal neoplasms: A prospective study of 50 cases in 45 patients in Vietnam.

Abstract

104 Background: Endoscopic submucosal dissection (ESD) is established as a curative modality for early gastrointestinal neoplasms in Japan and Korea, with high en bloc resection rates and favorable outcomes. In Vietnam, ESD has been increasingly adopted, mainly for gastric and colorectal lesions, but published data remain limited. Evidence for less common sites such as the hypopharynx and anal canal is scarce. This study reports prospective data from 45 consecutive patients undergoing 50 ESD procedures at a tertiary hospital. Notably, hypopharyngeal neoplasms accounted for 4% of cases, higher than international reports (<2%). Methods: A prospective study was conducted on 45 patients with early-stage gastrointestinal neoplasms who underwent 50 ESD procedures at the Gastroenterology Department of 19-8 Hospital, Hanoi, between September 2023 and February 2026. Results: The mean procedure time was 112 minutes (range, 62–180 minutes). Tumor diameters ranged from 6 to 45 mm. The en bloc resection rate was 98%. One patient experienced perforation requiring surgical intervention, and the post-procedural hemorrhage rate was 2%. The median hospital stay was 5 days (range, 3–8 days). Tumor locations included the hypopharynx (2 cases, 4%), esophagus, stomach, colorectum, and anal canal (2 cases, 4%). Importantly, both anal canal neoplasms were resected safely, sparing patients from permanent colostomy. Most patients were in stage Tis (72%), with only 4% in stage T1b. At one-year follow-up, recurrence was observed in two patients: one with a hypopharyngeal neoplasm and one with an esophageal neoplasm, both treated successfully with ESD. Conclusions: ESD is effective and safe for early gastrointestinal neoplasms in Vietnam, achieving curative resection with precise histology. Complications were rare and manageable. The high proportion of hypopharyngeal neoplasms highlights careful inspection during routine endoscopy. Successful anal canal resections underscore ESD’s role in organ preservation. These findings expand evidence beyond gastric cancer and support integration of ESD into early detection strategies in resource-limited settings.