The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Endoscopic submucosal dissection (ESD) of oesophageal dysplasia and neoplasia.
This procedure can be used to treat abnormalities in the lining of the oesophagus. A long camera (endoscope) is inserted through the mouth and into the oesophagus to view the affected area. A solution is injected into the wall of the oesophagus, and then the abnormal part of its lining is removed with special instruments. The aim of the procedure is to avoid the need for open surgery, and to obtain a good-quality sample for examination under the microscope.
This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take this guidance fully into account. However, the guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.
Commissioners and/or providers have a responsibility to implement the guidance, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.