BACKGROUND: EMR and endoscopic submucosal dissection (ESD) are now being increasingly used for the treatment of esophageal cancers. However, their efficacies in smaller lesions have not been compared. OBJECTIVE: For effective use of these methods, we compared the results of ESD and 2 major EMR methods for treating esophageal cancers of <or=20 mm. DESIGN: A retrospective study. SETTING: A cancer-referral center. PATIENTS: A total of 136 patients with 171 lesions <or=20 mm who presented between January 2002 and October 2007 were enrolled. MAIN OUTCOME MEASUREMENTS: En bloc and curative resection. RESULTS: Of the 171 lesions, 168 were squamous-cell carcinoma and 3 were adenocarcinoma. The en bloc resection rates decreased in the order of ESD (100%), EMR using a transparent cap (EMRC) (87%), and 2-channel EMR (71%). However, the differences showed only marginal significance. The curative resection rate of ESD (97%) was significantly higher than those of the other 2 methods. Furthermore, the curative resection rate of EMRC (71%) was significantly higher than that of 2-channel EMR (46%). In lesions <15 mm, the en bloc and curative resection rates were significantly higher for EMRC (100% and 86%, respectively) than 2-channel EMR (86% and 51%, respectively), whereas no significant differences were found between the en bloc and curative resection rates of EMRC and ESD. There were no differences in the complication rates. LIMITATIONS: A single-center, retrospective analysis. CONCLUSIONS: ESD was found to be the best endoscopic resection method, even for smaller esophageal cancers. EMRC would be a good alternative to ESD for lesions <15 mm.
BACKGROUND: EMR and endoscopic submucosal dissection (ESD) are now being increasingly used for the treatment of esophageal cancers. However, their efficacies in smaller lesions have not been compared. OBJECTIVE: For effective use of these methods, we compared the results of ESD and 2 major EMR methods for treating esophageal cancers of <or=20 mm. DESIGN: A retrospective study. SETTING: A cancer-referral center. PATIENTS: A total of 136 patients with 171 lesions <or=20 mm who presented between January 2002 and October 2007 were enrolled. MAIN OUTCOME MEASUREMENTS: En bloc and curative resection. RESULTS: Of the 171 lesions, 168 were squamous-cell carcinoma and 3 were adenocarcinoma. The en bloc resection rates decreased in the order of ESD (100%), EMR using a transparent cap (EMRC) (87%), and 2-channel EMR (71%). However, the differences showed only marginal significance. The curative resection rate of ESD (97%) was significantly higher than those of the other 2 methods. Furthermore, the curative resection rate of EMRC (71%) was significantly higher than that of 2-channel EMR (46%). In lesions <15 mm, the en bloc and curative resection rates were significantly higher for EMRC (100% and 86%, respectively) than 2-channel EMR (86% and 51%, respectively), whereas no significant differences were found between the en bloc and curative resection rates of EMRC and ESD. There were no differences in the complication rates. LIMITATIONS: A single-center, retrospective analysis. CONCLUSIONS: ESD was found to be the best endoscopic resection method, even for smaller esophageal cancers. EMRC would be a good alternative to ESD for lesions <15 mm.
Authors: Daniel von Renteln; Melina C Vassiliou; Karel Caca; Arthur Schmidt; Richard I Rothstein Journal: Surg Endosc Date: 2010-12-07 Impact factor: 4.584
Authors: Zhong-Sheng Lu; Yun-Sheng Yang; Dan Feng; Shu-Fang Wang; Jing Yuan; Jin Huang; Xiang-Dong Wang; Jiang-Yun Meng; Hong Du; Hong-Bin Wang Journal: World J Gastroenterol Date: 2012-12-21 Impact factor: 5.742