Evaluating indications and safety of ESD under general anesthesia in the endoscopy room

Abstract

Background: ESD under general anesthesia (GA-ESD) is known to improve procedural stability and patient safety. Given the limited availability of operating room, GA-ESD in the endoscopy room has been implemented. This study evaluated its indications and safety.

Methods: We retrospectively analyzed clinical background and perioperative complications in 194 upper gastrointestinal GA-ESD cases (169 in the endoscopy room and 25 in the operating room) between January 2020 and December 2024. High-risk patients for anesthesia underwent ESD in the operating room.

Results: All procedures were completed without intraoperative anesthesia-related complications. Complications occurred in 45 cases (39 in the endoscopy room and 6 in the operating room) and were managed conservatively without severe outcomes.

Conclusion: With appropriate patient selection and anesthesiologist monitored care, GA-ESD in the endoscopy room is a feasible and safe alternative.