To characterize the current landscape of independent ESD practice in the UK, focusing on workforce characteristics, training pathways, procedural volumes, service provision, technical approaches, perceived barriers, and endoscopists’ views on robotics in ESD.
Key Findings:
28 eligible responses received, with a majority aged 40-59 years and male, indicating a need for diversity in age and gender.
Most respondents were gastroenterologists with significant consultant experience, suggesting a well-established workforce.
67.9% of respondents completed an advanced endoscopy fellowship, primarily in the UK and Japan, highlighting the importance of specialized training.
82.1% received formal ESD training through accredited courses, which is crucial for standardizing practice.
Interpretation:
The study highlights the current state of ESD practice in the UK, revealing a well-experienced workforce with substantial training, yet indicating potential barriers to wider adoption, such as institutional challenges and limited case availability.
Limitations:
Small sample size with only 28 responses, which may limit generalizability.
No formal a priori sample size or power calculation performed, raising questions about the robustness of the findings.
Study did not collect procedural or clinical outcome measures, which are essential for evaluating the effectiveness of ESD.
Conclusion:
As expertise and training pathways improve, ESD is expected to gain relevance in Western practice, enhancing minimally invasive oncological approaches, but addressing the identified barriers will be crucial for its broader adoption.
In the phase 3 PANOVA-3 trial, adding Tumor Treating Fields therapy to gemcitabine and nab-paclitaxel was associated with improved overall survival and delayed pain progression in adults with locally advanced pancreatic cancer.
