Comparison of endoscopic piecemeal mucosal resection and endoscopic submucosal dissection for treatment of esophageal mucosal lesion larger than 15mm
10.3760/cma.j.issn.1007-5232.2017.06.003
- VernacularTitle:内镜分片黏膜切除术与黏膜下剥离术治疗直径大于15mm食管黏膜病变的对比研究
- Author:
Mengjiang HE
;
Quanlin LI
;
Weifeng CHEN
;
Yiqun ZHANG
;
Yunshi ZHONG
;
Lili MA
;
Meidong XU
;
Pinghong ZHOU
- Keywords:
Therapeutic endoscopy;
Endoscopic submucosal dissection;
Endoscopic piecemeal mucosal resection;
Esophageal neoplasm
- From:
Chinese Journal of Digestive Endoscopy
2017;34(6):389-393
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the clinical value of endoscopic piecemeal mucosal resection (EPMR) and endoscopic submucosal dissection (ESD) for treatment of esophageal mucosal lesion with diameter larger than 15 mm.Methods The data of 261 patients with esophageal mucosal lesions ≥15 mm and undergoing ESD (n=198) or EPMR (n=63) in Endoscopy Center of Zhongshan Hospital from September 2009 to August 2011 were retrospectively analyzed.Therapeutic effect, complications, and local recurrence were compared between the two groups.Results The lesion size was significantly larger in the ESD group than that in the EPMR group (3.02±1.13 mm VS 2.66±0.95 mm, P<0.05).The rates of en bloc resection, complete resection, and curative resection were 100% (198/198), 96% (190/198), and 94% (187/198), respectively in the ESD group.Only samples with horizontal margin obtained the pathological assessment in the EPMR group, and 2 cases were positive.The incidence of short-term complications including massive bleeding and perforation was no statistically different (P>0.05) between the two groups.The rate of postoperative esophageal stricture was higher in the EPMR group than that of the ESD group [22.6% (14/62) VS 6.2% (12/194),P<0.05] except for 5 cases with further surgery treatment (4 cases in the ESD group and 1 case in the EPMR group).The local recurrence rate was also higher in the EPMR group than that of the ESD group [11.5% (7/61) VS 3.7% (7/190), P<0.05], except for 10 cases with positive margin.Conclusion The therapeutic effect of ESD is superior to that of EPMR for esophageal mucosal lesions with diameter larger than 15 mm due to lower rate of local recurrence and acceptable complications.
