Current status and future perspective of ESD in Thailand

Current status and future perspective of ESD in ThailandRapat Pittayanon, MD., M.Sc.Gastroenterology Unit, King Chulalongkorn Memorial Hospital, Bangkok, Thailand. Endoscopic submucosal resection (ESD) is the established well-known procedure for curative treatment in early esophageal, gastric and colonic cancer. In the past, these cancers were rarely found in Thailand. They almost always presented in advanced stage and gastric cancer was issued as the fourth leading cause of death in Thailand in the last 10 years. Consequently, ESD was not noticed by Thai gastroenterologists. Currently, even though, Thai populations do recognize in their health and the rate of annual check-up is increasing, the rate of early luminal cancer detection is still stable. This may be due to the limited knowledge in early luminal cancer diagnosis in Thailand because some University Hospitals which perform ESD, including King Chulalongkorn Memorial Hospital, Chiang Mai University and Rajavithi Hospital, can get some cases, especially in early rectal and colonic cancer. Therefore, instead of teaching ESD, how to diagnose early esophageal, gastric and colonic cancer should be mentioned in Thailand earlier.