Naohisa Yahagi, luminary of digestive endoscopy, at the Cancer Center of Keio University in Tokyo where he works, stays there for a month a year when things go well. The rest he spends traveling the world, from Asia to Europe to the Americas, to teach the technique that he invented 25 years ago and which changed the history of gastrointestinal tumors: it's called ESD (endoscopic submucosal dissection) and with special needles used as scalpels it allows early lesions to be removed in a single block, completely saving the organ affected by the cancer. This month Yahagi's infinite journey stopped in Legnano, in the leading hospital of the 4 facilities that belong to theWest Milanese Asst. Something like 20 interventions in 10 days, to perfect the team directed by Pietro Gambitta who cultivates a dream: “To create a school on this revolutionary method here in the company, thanks to the collaboration with Japan and the synergy with the university”.
“ESD is the most powerful and reliable technique of endoscopic resection“, explains Yahagi who was celebrated last night in Legnano with a ceremony in the Coat of Arms Hall of the Municipality, in the presence of the top management of the local social health company and the city and regional authorities. “It also allows difficult cases to be treated – underlines the specialist, professor of Medicine and director of the Research and Development Division for minimally invasive treatments at the Cancer Center of the Keio University School of Medicine – guaranteeing the patient a good quality of life, preserving gastrointestinal function and preventing the risk of local tumor recurrence. A 'super soft' method that combines with therapeutic strength also an diagnostic value. In fact, it allows “a precise histological evaluation” of the lesion, a further guarantee against future relapses.
“ESD allows you to resect early tumors in the entire digestive system – from the esophagus to the stomach, from the duodenum to the colon, up to the rectum – with the same radicality and the same curative effect as surgery, but without any demolition. It means preserving the organ and at the same time the patient's quality of life. No amputations, no 'bag'“, highlights Gambitta, director of the Complex Structure of Gastroenterology and Digestive Endoscopy of the Asst Ovest Milanese, who brought the technique into the company, with 200 ESD operations performed in 5 years. “It means almost not realizing that you have been operated on: a result even more precious – specifies the head doctor – considering the increasingly advanced age of our patients”.
It is no coincidence that ESD was born in Japan, as a minimally invasive endoscopic method for the resection of superficial stomach carcinomas, which are particularly frequent in the Land of the Rising Sun. Following “one learning curve” which experts define as “long and complex”, over the years the technique has grown to the point of being adopted in the treatment of tumors throughout the gastrointestinal district.
Gambitta insists on the importance of intervention “especially against the colon cancer. We observe an exponential increase of these tumors, while those of the esophagus and stomach are decreasing”, he specifies to Adnkronos Salute. “In Lombardy we see a lot of early neoplasms of the colon, intercepted thanks to a regional screening program which records constantly increasing numbers: if until 2 years ago in the hospital we calculated that we would carry out 10 colonoscopies every day on 'screening' patients who tested positive for occult blood in the faeces – the specialist reports during the Legnano meeting – today we do 20 a day. A +100%, double”. This translates into “an enormous amount of early colorectal tumors, sometimes benign, but often malignant. So think about the importance of being able to remove them in a minimally invasive way, completely preserving the organ and its functionality, saving the patient and at the same time his quality of life.”
The one between Yahagi and Gambitta is “a continuous exchange – says the head doctor of the Legnano Asst – He comes here to improve us and I also often go to Japan, from where I imported this method around which I would like to build a school“, is the ambition of the student who in turn became a teacher. Gambitta is keen to send a message: “Lately we only talk about medical malpractice, about what doesn't work. But it is a narrative that does not reflect our daily life, made up of many good news like this. Made up of doctors, nurses and healthcare workers who work hard every day to improve patients' lives. This too should be said.”
He expresses “satisfaction and pride for these very important synergies” Francesco Laurelli, since the beginning of 2024 general director of the Asst Ovest Milanese, where “every year we count 4,700 oncology hospitalizations, both surgical and medical, and 18 thousand gastroenterology services”. The objective, he states, is to enhance the “role of our structure as a point of reference for innovative techniques like this”, in a process of “constant evolution in research, in the acquisition of new instruments, procedures and skills, and in training, encouraging the presence of young specialists”. Without forgetting that “behind every technology there are peoplethe true beating heart of healthcare”.
To greet and thank Yahagi – who on Saturday 13 April will illustrate the past, present and future of ESD during a scientific conference in Stresa, on Lake Maggiore – among others, Aldo Bruno Giannì of the State University of Milan, president of the Management Committee of the Faculty of Medicine and Surgery; the Councilor for Transport and Sustainable Mobility of the Lombardy Region, Franco Lucente; Silvia Scurati, regional councilor of the League, and the mayor of Legnano Lorenzo Radice. “This year – he declares – we celebrate the centenary of Legnano City, under the slogan 'Legnano, an open and welcoming city'. Hosting Professor Yahagi honors us and is a signal, a symbol of the richness brought by openness to knowledge and learning. One hundred years ago Legnano became a city and the hospital was there”, the mayor wanted to recall. “Legnano and its hospital are one”.
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