ESD as a bridge to perform complex procedures, combining endoscopic and surgical approach - own experience.Outstanding Poster Award

ESD is an advanced endoscopic technique used to treat early digestive tract cancer. With gaining more experience, one must develop more sophisticated skills like managing the bleeding and perforation, as well as properly operating the instrument during dissection. In this paper we present the results of advaned endoscopic and surgical procedures, which were introduced after successful implementation of ESD technique.Results:191 endoscopic submucosal dissection were performed from June 2013 to March 2016. After 100 procedures, POEM technique for treatment of achalasia was than introduced. Till now, 5 POEMs were performed reporting good functional results with no post procedural complications. Moreover, two R0 transmural resections for gastric submucosal tumors of 2 cm and 3cm in diameter respectively were achieved. In larger tumors, hybrid laparoendoscopic technique was used twice. We also utilized the OTS clips in definitive management of intestinal fistulas of various origins in duodenum or sigmoid colon.Conclusions: ESD is not only feasibly endoscopic technique to treat early tumors of the gastrointestinal tract, but also allows for the development of endoscopic skills, which can enable performing even more complex procedures combing surgical and endoscopic approach.