Yasuaki Furue1,2, Chikatoshi Katada3, Satoshi Tanabe4, Kenji Ishido1, Yuki Kondo1, Yo Kubota1, Natuko Kawanishi1, Sakiko Yamane1, Akinori Watanabe1, Hiromitsu Moriya5, Keishi Yamashita5, Takuya Wada1, Takafumi Yano1, Mizutomo Azuma1, Wasaburo Koizumi1. 1. Department of Gastroenterology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan. 2. Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Kashiwa, Japan. 3. Department of Gastroenterology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan. ckatada@med.kitasato-u.ac.jp. 4. Research and Development Center for New Frontier, Kitasato University School of Medicine, Sagamihara, Japan. 5. Department of Surgery, Kitasato University School of Medicine, Sagamihara, Japan.
Abstract
BACKGROUND: Endoscopic submucosal dissection (ESD) has been performed in a high proportion of patients with superficial esophageal squamous-cell carcinoma. Endoscopic aspiration mucosectomy (EAM) is a more straightforward technique that is easier to perform. We retrospectively evaluated the safety and efficacy of EAM and ESD to clarify the advantages and disadvantages of each procedure. METHODS: A total of 374 patients (423 lesions) who underwent endoscopic resection were retrospectively studied. The following variables were evaluated (1) procedure time and adverse events as safety, and (2) en bloc complete resection rate, local recurrence rate, lymph node recurrence rate, overall survival rate, and cause-specific survival rate as efficacy. RESULTS: EAM was performed in 134 patients (149 lesions), and ESD was performed in 240 patients (274 lesions). The procedure times of EAM and ESD were 31.0 ± 22.4 and 85.7 ± 46.5 min (p < 0.001), respectively. The perforation rates were 0 and 6.2% (p = 0.002), respectively. The en bloc complete resection rates were 48.3 and 91.6% (p < 0.001), respectively. The local recurrence rates were 5.5 and 0% (p < 0.001), respectively. For lesions measuring less than 15 mm in diameter, EAM had a relatively good en bloc complete resection rate (EAM, 76.1% vs. ESD, 100%) and a significantly short procedure time (EAM, 25.2 ± 15.2 min vs. ESD, 62.7 ± 35.2 min; p < 0.001). CONCLUSIONS: ESD has a higher en bloc complete resection rate and a better local control rate than EAM. For lesions measuring less than 15 mm in diameter, EAM may be a treatment option.
BACKGROUND: Endoscopic submucosal dissection (ESD) has been performed in a high proportion of patients with superficial esophageal squamous-cell carcinoma. Endoscopic aspiration mucosectomy (EAM) is a more straightforward technique that is easier to perform. We retrospectively evaluated the safety and efficacy of EAM and ESD to clarify the advantages and disadvantages of each procedure. METHODS: A total of 374 patients (423 lesions) who underwent endoscopic resection were retrospectively studied. The following variables were evaluated (1) procedure time and adverse events as safety, and (2) en bloc complete resection rate, local recurrence rate, lymph node recurrence rate, overall survival rate, and cause-specific survival rate as efficacy. RESULTS: EAM was performed in 134 patients (149 lesions), and ESD was performed in 240 patients (274 lesions). The procedure times of EAM and ESD were 31.0 ± 22.4 and 85.7 ± 46.5 min (p < 0.001), respectively. The perforation rates were 0 and 6.2% (p = 0.002), respectively. The en bloc complete resection rates were 48.3 and 91.6% (p < 0.001), respectively. The local recurrence rates were 5.5 and 0% (p < 0.001), respectively. For lesions measuring less than 15 mm in diameter, EAM had a relatively good en bloc complete resection rate (EAM, 76.1% vs. ESD, 100%) and a significantly short procedure time (EAM, 25.2 ± 15.2 min vs. ESD, 62.7 ± 35.2 min; p < 0.001). CONCLUSIONS: ESD has a higher en bloc complete resection rate and a better local control rate than EAM. For lesions measuring less than 15 mm in diameter, EAM may be a treatment option.
Authors: C Katada; M Muto; K Momma; M Arima; H Tajiri; C Kanamaru; H Ooyanagi; H Endo; T Michida; N Hasuike; I Oda; T Fujii; D Saito Journal: Endoscopy Date: 2007-09 Impact factor: 10.093
Authors: Yue-Ming Zhang; David F Boerwinkel; Xiumin Qin; Shun He; Liyan Xue; Bas L A M Weusten; Sanford M Dawsey; David E Fleischer; Li-Zhou Dou; Yong Liu; Ning Lu; Jacques J G H M Bergman; Gui-Qi Wang Journal: Endoscopy Date: 2015-11-06 Impact factor: 10.093
Authors: H Y Wang; X Zeng; S Y Bai; K Pu; Y Zheng; R Ji; Q H Guo; Q L Guan; Y P Wang; Y N Zhou Journal: Ann R Coll Surg Engl Date: 2020-08-21 Impact factor: 1.891