Endoscopic therapies are ever-changing strategies and never-ending challenges for gastroenterological neoplasia and the refractory conditions

Endoscopic mucosal resection (EMR) is accepted as a treatment of choice for early gastrointestinal (GI) cancers and tumors. Nevertheless, snaring-based procedure of the EMR is limited in the lesion size and is not reliable for lesions with ulcer findings. Endoscopic submucosal dissection (ESD) has been developed as an endoluminal therapeutic technique for superficial GI neoplasia. ESD has the advantage over EMR with respect to curative resection, removing even extensive GI tumors or ulcerated gastric cancer in the early stage in an en bloc manner. ESD allows precise histological assessment of the resected one-piece specimens in order to guide further management and to stratify a patient’s risk for developing metastasis.