Gastric cancer is among the commonest cancers all over the world. Treatment of this cancer at an early stage will result in a significantly better prognosis. Endoscopic submucosal dissection (ESD) is a new method of endoscopic resection that can achieve higher rates of en bloc resection and curative resection with lower recurrence rates than endoscopic mucosal resection (EMR) for treatment of early gastric cancers. ESD achieved similar clinical outcomes when compared with radical gastrectomy for treatment of early gastric cancer. Patients receiving ESD had better perioperative outcomes in terms of operative time

complication rate

and hospital stay. However

compared to EMR

ESD requires a longer procedure time and a higher level of technical expertise

in addition to having a slightly greater risk of complications. Perforation and bleeding are the major complications associated with gastric ESD. Endoscopists must be aware of not only the risk factors for and incidence of complications

but also how to effectively treat such complications. Endoscopists should undergo a dedicated training program before starting ESD.