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Endoscopic submucosal dissection for superficial esophageal cancer with near-circumferential lesions: our experience with 40 patients

Abstract

Background

Nowadays, there are few reports indicating whether early esophageal cancers (EsC) with near-circumferential lesions are still appropriate for the endoscopic submucosal dissection (ESD) procedure.

Methods

Between November 2009 and December 2013, a total of 40 patients with early esophageal cancers were treated with ESD. The characteristics of the patients, the ESD procedure variables, the rates of en bloc resection, and the major complications were evaluated. The outcomes listed were reliably followed up, and postoperative endoscopic balloon dilation was conducted to treat the esophageal strictures.

Results

A total of 40 patients with superficial esophageal cancers were treated with ESD procedure. The extent of the lesions as a proportion of the whole circumference of the esophageal lumen ranged from three-quarters (18/40) to four-fifths (4/40) and complete circumference (18/40). The median longitudinal diameter of the lesions was 50 mm. The median procedure time was 92.5 min (range, 70–125 min). The en bloc resection rate was 100 % (40/40). Immediate bleeding, perforation, and postoperative stenosis were noted in 7.5 (3/40), 7.5 (3/40), and 45 % (18/40) of the patients. The median number of endoscopic balloon dilations (EBDs) was 4 (range 1–14). Additional surgical treatment was performed in 2 cases, and local recurrence was detected in 1 patient (2.5 %). 2 patients (5 %) died of EsC 3 months after ESD.

Conclusions

These data will greatly expand the criteria for the use of ESD in esophageal cancer and increase the number of patients eligible for endoscopic treatment and the acceptance of the ESD procedure.

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Disclosures

Bo Tang, Jian-Ying Bai, Xiao-Yan Zhao, Chao-Qiang Fan, Xin Yang, Lei Deng, Shi-Ming Yang, and Jing Yu have no conflicts of interest or financial ties to disclose.

Author information

Correspondence to Shi-Ming Yang or Jing Yu.

Additional information

Bo Tang and Jian-Ying Bai have contributed equally to this study.

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Tang, B., Bai, J., Zhao, X. et al. Endoscopic submucosal dissection for superficial esophageal cancer with near-circumferential lesions: our experience with 40 patients. Surg Endosc 29, 2141–2148 (2015). https://doi.org/10.1007/s00464-014-3909-8

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Keywords

  • Endoscopic submucosal dissection
  • Esophageal cancer
  • Near-circumferential
  • Endoscopic balloon dilation (EBD)