“Endoscopic resection” of superficial gastrointestinal neoplasia: a single key opening all the doors

We have read with great interest the position statement by Deprez et al. on the current practice with endoscopic submucosal dissection (ESD) in Europe [1]. The great effort made by the panel of experts should definitely be commended, as the article is extremely clear and gives a very balanced perspective on the potential role of ESD. The training and educational needs, as well as the technical proficiency required to safely perform this technique in standard practice are sharply focused and correctly addressed.

In particular, we were very pleased to read the following statement. “The terms ‘EMR’ or ‘mucosectomy’ are in fact inappropriate, as resection includes a part of the submucosa. They should therefore be replaced by the term ‘endoscopic resection.’”[1].

In fact, in this very Journal we first proposed the simplified, unifying term of “endoscopic resection” to comprehensively include all of the previous different terminologies so far adopted, from polypectomy to submucosal dissection [2]. In our opinion, these terms merely represent diverse technical modalities of performance of the same procedure.

Our semantic input was soon warmly welcomed by the Japanese authors in their reply letter: “…these methods can be unified under the special term of ‘endoscopic resection.’ We think that the unified term should be considered for the technique to dissect submucosa by special dissecting devices. … We hope that the term ‘endoscopic resection’ and its definition will be discussed at international conferences in the near future.” [3].

We have always believed that a single term would be advisable to simplify the description of these complex procedures. To see that now our view is also shared by renowned European experts in the field strengthens our conviction in the use of a simplified unifying term.

References

• 1 Deprez P H, Bergman J J, Meisner S et al. Current practice with endoscopic submucosal dissection in Europe: position statement from a panel of experts.  Endoscopy. 2010;  42 853-858
• 2 Cipolletta L, Rotondano G, Bianco M A. Can we simplify terminology in the endoscopic treatment of superficial gastrointestinal neoplasia? Yes, we can.  Endoscopy. 2010;  42 178
• 3 Yoshida N, Nagi N, Naito Y. Reply to Cipolletta et al. [letter].  Endoscopy. 2010;  42 178