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Utility of double endoscopic intraluminal operation for esophageal cancer

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Abstract

Objectives

Endoscopic submucosal dissection (ESD) is a more difficult technique for esophageal cancer than for gastric cancer because the working space for esophageal ESD is small. Further, the difficulty level gradually increases depending on the size of the carcinoma. To overcome these difficulties, double endoscopic intraluminal operation (DEILO), which enables the resection of mucosal lesions using two fine endoscopes and monopolar shears, was reported previously. Here, we report the utility of DEILO for esophageal cancer.

Methods

A total of 26 esophageal cancer patients (19 men and seven women) with 26 lesions treated using DEILO between 2011 and 2014 at Gunma University Hospital were included. We evaluated the utility and safety of DEILO for early esophageal cancer.

Results

For all patients (100%), the DEILO procedure was performed successfully, and en bloc resection was achieved. The median operation time, postoperative hospital stay, and the longitudinal dimension of resected specimens were 123 min (range 45–236 min), 5 days, and 32 mm, respectively. Perioperative perforation, pneumothorax, and mediastinal emphysema were not recognized. Only one patient was diagnosed with a postoperative hemorrhage, but the bleeding was successfully treated by bleeding vessel coagulation.

Conclusion

DEILO has good utility as a technique of ESD for early esophageal cancers. Additional improvement and advancement of the procedure will increase the indication of DEILO.

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Correspondence to Makoto Sohda.

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Disclosures

Makoto Sohda, Hideyuki Saito, Tomonori Yoshida, Yuji Kumakura, Hiroaki Honjyo, Keigo Hara, Daigo Ozawa, Shigemasa Suzuki, Naritaka Tanaka, Makoto Sakai, Tatsuya Miyazaki, Minoru Fukuchi, and Hiroyuki Kuwano have no conflicts of interest or financial ties to disclose.

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Sohda, M., Saito, H., Yoshida, T. et al. Utility of double endoscopic intraluminal operation for esophageal cancer. Surg Endosc 31, 3333–3338 (2017). https://doi.org/10.1007/s00464-016-5368-x

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  • DOI: https://doi.org/10.1007/s00464-016-5368-x

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