Healthcast: ESD: Japanese treatment for colon polyps catching on here?


Almost half of all adults in the U.S. develop colon polyps during their lifetime, growths that are often benign, but sometimes develop into cancer. Now, one doctor at Mt. Sinai hospital in New York is advocating a procedure developed in Japan for removing and testing some of them.

Fifty-year-old Jaime Reid is bouncing back from a health scare that could have set him back for weeks. During a routine colonoscopy, doctors found a polyp.

While most mushroom-like polyps are removed endoscopically with a surgical tool that snares the growth, Reid’s polyp was too large and flat. The traditional option would have been to remove that section of the colon.

“It would have meant another five days in the hospital. Probably a week out of work,” Reid said.

Instead, Reid had a procedure called ESD or endoscopic submucosal dissection. Using an endoscope, doctors inject fluid into the layer of the bowel next to the polyp-creating a working space. Then doctors use the scope to deliver an electric current, like a laser.

“The scope is being used to actually draw around the lesion and cut layer by layer to get the polyps removed,” said Richard Whelan, MD, a colorectal surgeon at Mt. Sinai.

Dr. Whelan is one of only a handful of surgeons and GI doctors performing ESD in the United States. He says doctors need more training, and hospitals will need to invest in specialized equipment before ESD can catch on.

For Reid, ESD meant only one day in the hospital.

“I was at work four days later. That’s a success for me,” Reid said.

Dr. Whelan says Japan is about 15 years ahead of the United States in treating colon polyps with advanced endoscopy in part, because Japanese surgeons have more experience using ESD to treat stomach cancer, which is more prevalent in that country.

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