Comparison of endoscopic submucosal tunnel dissection with endoscopic submucosal dissection for esophageal superficial neoplasms: a retrospective study
10.3760/cma.j.issn.1007-5232.2018.04.001
- VernacularTitle:内镜黏膜下隧道法剥离术与传统内镜黏膜下剥离术治疗浅表性食管肿瘤的回顾性对比研究
- Author:
Rui HUANG
1
;
Xin ZHAO
;
Xiaoqiang LU
;
Min LIU
;
Wenhao LYU
;
Zhiguo LIU
Author Information
1. 第四军医大学西京医院消化内科
- Keywords:
Esophageal neoplasms;
Regression analysis;
Endoscopic submucosal dissection;
Tunnel technology
- From:
Chinese Journal of Digestive Endoscopy
2018;35(4):229-233
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the safety and efficacy of endoscopic submucosal tunnel dissection (ESTD) and endoscopic submucosal dissection ( ESD) for treatment of esophageal superficial neoplasms. Methods A retrospective study was performed on data of patients with esophageal superficial neoplasms who were treated by conventional ESD or ESTD at Xijing Hospital of Digestive Diseases between January 2014 and December 2016. The procedure time, pathology, rate of en bloc resection and curative resection, and adverse events were compared between the two groups. Results A total of 113 consecutive patients were collected, including 49 undergoing ESTD and 64 undergoing ESD. ESTD had a shorter procedure time than ESD method [38. 0 min(21. 4-71. 0 min) VS 46. 5 min(32. 5-117. 5 min), P＝0. 008],and the dissection speed of ESTD was faster than that of ESD[0. 42 cm2/min(0. 22-0. 59 cm2/min) VS 0. 34 cm2/min(0. 20-0. 42 cm2/min), P＝0. 000]. There were no statistical differences in the en bloc resection rate ( 100. 0% VS 100. 0%, P＝1. 000) or the curative resection rate (98. 0% VS 93. 8%, P＝0. 386).There were no statistical differences on adverse event rates including post-procedure bleeding, perforation, fever, and thoracalgia.ESTD group showed a lower rate of muscular injury (20. 4% VS 39. 1%, P＝0. 041) and intra-procedure bleeding (18. 4% VS 37. 5%, P＝0. 036). A multivariate regression analysis for procedure time showed that ESTD method ( OR＝ 2. 801, 95%CI: 1. 116-7. 031, P＝0. 028) and lesion area ＜9 cm2(OR＝5. 049, 95%CI: 2. 088-12. 208, P＝0. 000) were associated with a shorter procedure time.Conclusion ESTD is safe and effective for treatment of esophageal superficial neoplasms. It can shorten operative time, improve dissection speed, and reduce intra-procedure muscular layer injury and bleeding.
