The Clinical and Translational Research Group in Digestive Diseases at the Marqués de Valdecilla Research Institute (IDIVAL) has published an article on an innovative that could improve the safety of endoscopic treatment for early digestive neoplasms.
This technique, called Cold Endoscopic Submucosal Dissection (Cold-ESD), is a new way to perform endoscopic resections — that is, removals through the interior of the digestive tract — without the need to use electric scalpels, significantly reducing risks for patients.
“This technique allows us to remove early neoplasms from the digestive tract without, or with minimal, use of electric current from the electrosurgical knife. This reduces complications associated with electrocautery, such as intraprocedural perforations, delayed perforations, or post-polypectomy syndrome,” explains Dr. Miguel Fraile, lead author of the article.
The study presents the first human case in which a neoplastic lesion in the transverse colon, discovered during a routine colonoscopy, was removed using Cold-ESD. Thanks to this technique, professionals were able to resect the entire lesion in one piece, without damaging deeper tissues or causing side effects.
One of the major advances of this approach is that it adapts the concept of “cold resection” — meaning without heat — to the field of submucosal dissection, enabling the safer removal of larger or more complex lesions. The potential benefits of Cold-ESD could be comparable to those of other cold endoscopic resection techniques such as simple polypectomy or mucosal resection, which have already been shown to improve safety by reducing the risk of perforation, post-polypectomy syndrome, and delayed bleeding.
The article, titled “Cold-endoscopic submucosal dissection: time to go further?”, highlights that Cold-ESD could facilitate the routine implementation of submucosal dissection in particularly challenging locations such as the colon, where the wall is extremely thin and the risk of complications is higher.
The research team also emphasizes that the development of specific endoscopic devices for this technique will be key to its widespread implementation in hospitals.
Link to the article: https://www.thieme-connect.de/products/ejournals/abstract/10.1055/a-2626-3707
Caption: Miguel Fraile in the Endoscopy Unit at Marqués de Valdecilla University Hospital.
