J Gong1, B Y Zhou1, C B Liang1, H J Zhou1, H Y Wang1, Y Y Tan1, D L Liu1.
Abstract
BACKGROUND AND STUDY AIMS: Endoscopic submucosal dissection (ESD) has been established as a standard endoscopic method for treating esophageal superficial neoplasms, and it can be performed using a conventional or a tunneling method. The aim of the present study was to compare the safety and efficacy of tunneling ESD (t-ESD) and standard ESD (s-ESD) for treating large esophageal superficial neoplasms and to explore the risk factors for postoperative strictures. PATIENTS AND METHODS: Fifty-five consecutive patients with large esophageal superficial neoplasms were treated by t-ESD or s-ESD. Demographics, lesion characteristics, procedure-related parameters, and follow-up results were retrospectively collected to compare the efficacy and safety of these procedures. Multivariate analyses were conducted to determine the potential risk factors for postoperative strictures.
RESULTS: Of the 55 patients, 13 underwent t-ESD and 42 underwent s-ESD. The dissection speed of t-ESD was significantly faster than that of s-ESD (7.42±1.99 min/cm2 vs. 9.01±2.11 min/cm2, P<0.05). En bloc resection was achieved in 98.2% (54/55) of the cases, while R0 resection was achieved in 92.7% (51/55). Curative resection was achieved in 78.2% (43/55) of the cases. Fourteen patients (25.5%) had postoperative strictures, which resolved with endoscopic dilation and/or stent insertion. Circumferential involvement of >3/4 and lesion length of >3 cm were independent risk factors for strictures.
CONCLUSIONS: T-ESD is a safe and effective method for treating large esophageal superficial neoplasms with a faster dissection speed than s-ESD, but postoperative strictures may be encountered for lesions involving more than three-fourths of the circumference or longer than 3 cm. © Acta Gastro-Enterologica Belgica.
BACKGROUND AND STUDY AIMS: Endoscopic submucosal dissection (ESD) has been established as a standard endoscopic method for treating esophageal superficial neoplasms, and it can be performed using a conventional or a tunneling method. The aim of the present study was to compare the safety and efficacy of tunneling ESD (t-ESD) and standard ESD (s-ESD) for treating large esophageal superficial neoplasms and to explore the risk factors for postoperative strictures. PATIENTS AND METHODS: Fifty-five consecutive patients with large esophageal superficial neoplasms were treated by t-ESD or s-ESD. Demographics, lesion characteristics, procedure-related parameters, and follow-up results were retrospectively collected to compare the efficacy and safety of these procedures. Multivariate analyses were conducted to determine the potential risk factors for postoperative strictures.
RESULTS: Of the 55 patients, 13 underwent t-ESD and 42 underwent s-ESD. The dissection speed of t-ESD was significantly faster than that of s-ESD (7.42±1.99 min/cm2 vs. 9.01±2.11 min/cm2, P<0.05). En bloc resection was achieved in 98.2% (54/55) of the cases, while R0 resection was achieved in 92.7% (51/55). Curative resection was achieved in 78.2% (43/55) of the cases. Fourteen patients (25.5%) had postoperative strictures, which resolved with endoscopic dilation and/or stent insertion. Circumferential involvement of >3/4 and lesion length of >3 cm were independent risk factors for strictures.
CONCLUSIONS: T-ESD is a safe and effective method for treating large esophageal superficial neoplasms with a faster dissection speed than s-ESD, but postoperative strictures may be encountered for lesions involving more than three-fourths of the circumference or longer than 3 cm. © Acta Gastro-Enterologica Belgica.
Entities:
Keywords:
endoscopic submucosal dissection; endoscopic submucosal tunnel dissection; esophageal superficial neoplasms; stricture
Mesh：
Year: 2019
PMID： 31950800
Source DB: PubMed Journal: Acta Gastroenterol Belg ISSN： 1784-3227 Impact factor: 1.316