However, the first treatment causes mutilation and results in poor patient quality of life. Also, ESD, is expensive and the learning curve is steep, moreover, since it is not widely available, other alternatives such as combinations of surgery and endoscopy are often resorted to 3.
Sin embargo, el primer tratamiento es mutilante, genera mala calidad de vida y el segundo, la DSM, es costoso, requiere una curva de aprendizaje grande y no está ampliamente disponible lo cual obliga a la búsqueda de otras alternativas como combinar la cirugía con la endoscopia 3.