Efficacy and safety of endoscopic submucosal dissection for circular superficial esophageal cancer
10.3760/cma.j.cn321463-20230321-00133
- VernacularTitle:内镜黏膜下剥离术治疗环周食管表浅癌的疗效及安全性分析
- Author:
Xiaotan DOU
1
;
Jianhai WU
;
Ting ZHOU
;
Huimin GUO
;
Min CHEN
;
Tian YANG
;
Tingsheng LING
;
Xiaoqi ZHANG
;
Ying LYU
;
Lei WANG
;
Xiaoping ZOU
Author Information
1. 南京大学医学院附属鼓楼医院消化科，南京 210008
- Keywords:
Esophageal neoplasms;
Superficial esophageal cancer;
Circumferential lesions;
Endoscopic submucosal dissection;
Esophageal stenosis
- From:
Chinese Journal of Digestive Endoscopy
2024;41(2):117-120
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) for circular superficial esophageal cancer.Methods:A retrospective analysis was conducted on 74 consecutive cases of circular superficial esophageal squamous cell carcinoma treated with ESD at Nanjing Drum Tower Hospital from January 2015 to December 2019. The success rate of ESD, curative resection rate, incidence of complications, and additional treatment were mainly observed.Results:One case was transferred to surgery, and the remaining 73 cases successfully completed ESD treatment. The success rate of ESD was 98.6%. Postoperative pathology of ESD revealed that 39 cases achieved curative resection, with a curative resection rate of 53.4% (39/73). Intraoperative muscle layer injury occurred in 15 cases (20.5%), and intraoperative perforation occurred in 1 case (1.4%). Two cases (2.7%) experienced delayed bleeding, and one case (1.4%) experienced delayed perforation. Eleven cases were lost to follow-up, and the remaining 62 cases received follow-up for 36.4±19.0 months. Among the follow-up cases, 12 underwent additional surgery and 5 cases additional chemotherapy and radiotherapy. Among the 57 patients with follow-up data who did not underwent surgery, 49 developed esophageal stenosis after ESD, with an incidence rate of 86.0%.Conclusion:ESD for circular superficial esophageal cancer is generally safe, but it is prone to muscle layer injury during the operation, with a low curative resection rate, a high incidence of postoperative esophageal stenosis, and a high proportion of additional surgical procedures.
