Semantic Architecture and Knowledge Evolution of Endoscopic Submucosal Dissection Research: A Computational Bibliometric Analysis

Aim: The overarching intellectual structure, dominant thematic clusters, and longitudinal evolution of the endoscopic submucosal dissection (ESD) literature have yet to be systematically mapped. This study aims to characterize the semantic and thematic architecture of ESD research through computational text analytics and to reveal latent structural patterns and temporal dynamics within this domain. Methods: A corpus of 1,000 peer-reviewed publications was processed through an eight-stage computational pipeline that incorporated word embedding-based semantic analysis, unsupervised clustering, Latent Dirichlet Allocation (LDA) topic modeling, inter-topic network analysis, and temporal trend modeling. The primary outcome was characterization of the semantic architecture of ESD research, whereas secondary outcomes included topic relationships, temporal evolution, and model performance metrics. Results: Semantic analysis revealed two dominant clusters: a technically oriented domain encompassing device innovation and procedural optimization and a clinically oriented domain addressing therapeutic outcomes, organ-specific protocols, and adverse event management. Topic modeling identified nine coherent thematic categories, with limited integration between technical and clinical research trajectories. Temporal analysis revealed a pronounced post-2024 shift toward upper-gastrointestinal applications, particularly esophageal and gastric ESD, with relative stagnation in colorectal investigations. The optimal semantic clustering solution achieved a silhouette score of 0.215, while the nine-topic LDA model demonstrated a coherence score of 0.39. Conclusion: This study provides the first data-driven macro-structural characterization of the ESD literature, revealing a persistent bifurcation between technical innovation and clinical application streams. These findings offer a strategic framework to help clinicians, investigators, and curriculum developers identify priority areas for advancement in therapeutic endoscopy.