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Bridging Japan and the United States in the Intralumenal Diagnostic and Therapeutic Procedures
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Hiroyuki Aihara |
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Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Harvard Medical School |
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| Japan has been leading the field of intralumenal diagnostic and therapeutic endoscopy as represented by the development of magnifying endoscopy classification systems (pit pattern and JNET classifications) and endoscopic submucosal dissection (ESD). These successful achievements are based on the efforts of pioneers who had strong interests in pathological findings of gastrointestinal (GI) tumors. Magnifying endoscopy was developed in an effort to endoscopically observe the pathological findings as surface structural patterns, while ESD was developed by the pioneers who designed new endoscopic electrocautery knives, hemostatic forceps and attachment caps to facilitate en-bloc endoscopic resection of early-stage GI cancers. The excellent outcomes of these advanced technologies have been proven by several multicenter, prospective studies and meta-analyses in high-quality journals. However, despite the recognition, these technologies have not been widely accepted as a standard of care in western countries. This is partly due to the differences in the training system, insurance system and prevalence of diseases in the east and west. How can we bridge the gap between east and west? One solution would be more frequent collaborations between JGES and ASGE to hold training courses for these procedures to further accelerate the adoption of these advanced endoscopic procedures in the west. |
Index Term 1: magnifying endoscopy
Index Term 2: endoscopic submucosal dissection
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