Long-term outcomes of endoscopic submucosal dissection for superficial esophageal squamous cell neoplasms

Ono, Satoshi; Fujishiro, Mitsuhiro; Niimi, Keiko; Goto, Osamu; Kodashima, Shinya; Yamamichi, Nobutake; Omata, Masao

doi:10.1016/j.gie.2009.04.044

Cited by 396 publications

(198 citation statements)

References 28 publications

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“…The en bloc resection rate is greater than 90% (90 .6%-100%) [24,29,[45][46][47][48][49] . En bloc resection, meaning resection in a single piece, facilitates an accurate histological assessment and reduces the risk of recurrence.…”

Section: Outcomes Of Esophageal Esdmentioning

confidence: 96%

“…En bloc resection, meaning resection in a single piece, facilitates an accurate histological assessment and reduces the risk of recurrence. In fact, the local recurrence rate after esophageal ESD is extremely low (0%-3.1%) [24,29,[45][46][47][48][49] . In contrast, the local recurrence of SCCs after EMR was reported to be as high as 20% because en bloc resection by EMR is difficult and multiple resections are required for large lesions [17] .…”

Section: Outcomes Of Esophageal Esdmentioning

confidence: 98%

“…Ono et al [45] reported that 15 of 84 (18%) patients treated by esophageal ESD experienced esophageal stricture and were successfully managed with EBD in a median of two sessions (range 1-20). Moreover, the authors recommended preventive EBD for cases of mucosal defect exceeding 75% of the esophageal circumference.…”

Section: Management Of Esophageal Stricture After Esdmentioning

confidence: 99%

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Endoscopic submucosal dissection for superficial esophageal squamous cell neoplasms

Honda

Akiho

2012

WJGP

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Endoscopic resection is an effective treatment for noninvasive esophageal squamous cell neoplasms (ESCNs). Endoscopic mucosal resection (EMR) has been developed for small localized ESCNs as an alternative to surgical therapy because it shows similar effectiveness and is less invasive than esophagectomy. However, EMR is limited in resection size and therefore piecemeal resection is performed for large lesions, resulting in an imprecise histological evaluation and a high frequency of local recurrence. Endoscopic submucosal dissection (ESD) has been developed in Japan as one of the standard endoscopic resection techniques for ESCNs. ESD enables esophageal lesions, regardless of their size, to be removed en bloc and thus has a lower local recurrence rate than EMR. The development of new devices and the establishment of optimal strategies for esophageal ESD have resulted in fewer complications such as perforation than expected. However, esophageal stricture after ESD may occur when the resected area is larger than three-quarters of the esophageal lumen or particularly when it encompasses the entire circumference; such a stricture requires multiple sessions of endoscopic balloon dilatation.Recently, oral prednisolone has been reported to be useful in preventing post-ESD stricture. In addition, a combination of chemoradiotherapy (CRT) and ESD might be an alternative therapy for submucosal esophageal cancer that has a risk of lymph node metastasis because esophagectomy is extremely invasive; CRT has a higher local recurrence rate than esophagectomy but is less invasive. ESD is likely to play a central role in the treatment of superficial esophageal squamous cell neoplasms in the future.

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Section: Outcomes Of Esophageal Esdmentioning

confidence: 96%

Section: Outcomes Of Esophageal Esdmentioning

confidence: 98%

Section: Management Of Esophageal Stricture After Esdmentioning

confidence: 99%

See 1 more Smart Citation

Endoscopic submucosal dissection for superficial esophageal squamous cell neoplasms

Honda

Akiho

2012

WJGP

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“…The ESD procedure, an application of conventional EMR, has been developed and established in Japan (4). ESD has relatively high complication rates; the notification of perforation risk is essential especially in the esophagus (1,5). Bleeding during ESD can be managed by endoscopic hemostasis with soft coagulation by forceps.…”

Section: Introductionmentioning

confidence: 99%

Management of strictures after endoscopic submucosal dissection for superficial esophageal cancer

Kawaguchi¹,

Kurumi²,

Takeda³

et al. 2017

Ann. Transl. Med.

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Endoscopic resection of early esophageal cancer has a high therapeutic effect while being minimally invasive. Especially, the establishment of the endoscopic submucosal dissection (ESD) procedure has made it possible to resect large lesions in an en-bloc manner. As a result, accurate pathology evaluation became possible, and the risk of local recurrence was extremely low. On the other hand, esophageal strictures after endoscopic treatment of an extensive circumferential lesion are a potential problem. Previously, for the prevention and treatment of esophageal strictures, patients had to undergo painful endoscopic balloon dilation (EBD) many times. It is, however, associated with complications (perforation, bleeding, etc.). For this, oral intake and/or a local injection of steroids were given and EBD sessions were less frequently or even unnecessarily performed. Furthermore, oral mucosa epithelial cell sheet transplantation and biodegradable stents are applied for controlling post-ESD stricture. Nevertheless, EBD was still the treatment option for refractory cases of stenosis. Recently, endoscopic radial incision and cutting methods have been applied to esophageal post-procedural strictures and even for anastomotic strictures following surgery. Thus, it is now becoming possible to treat circumferential lesions with ESD and to control the resultant stenosis.

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“…Endoscopic submucosal dissection (ESD) is widely known as an effective treatment for superficial gastrointestinal neoplasms. ESD enables en bloc complete resection of tumors, regardless of their location and size (6)(7)(8). With technological progress of ESD, endoscopic fullthickness resection (EFTR) techniques have been developed for gastric SETs (9)(10)(11)(12)(13)(14)(15)(16).…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic and endoscopic cooperative surgery for gastrointestinal tumor

Niimi¹,

Ishibashi²,

Mitsui³

et al. 2017

Ann. Transl. Med.

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With technological progress of endoscopic submucosal dissection (ESD) in the last decade, several laparoscopic and endoscopic cooperative surgeries (LECS) for gastrointestinal tumor have recently been developed.LECS is definitely favorable to the minimization of surgical margin, which leads to functional and anatomical preservation of gastrointestinal tract. LECS for gastrointestinal tumor is mainly sorted by two categories: exposure procedures and non-exposure procedures between endoluminal and extraluminal spaces. Exposure procedures have the potential risk of gastric contents or tumor cells spilling out over the abdominal cavity, because the stomach wall has to be perforated intentionally during the procedure. In order to avoid the potential these risks, nonexposure procedures have been developed. Currently, the LECS concept has rapidly permeated for treatment of gastrointestinal tumor due to its certainty and safety, although there is still room for improvement to lessen its technical difficulty. This review describes the current LECS for gastrointestinal tumor based on the several articles.

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Long-term outcomes of endoscopic submucosal dissection for superficial esophageal squamous cell neoplasms

Cited by 396 publications

References 28 publications

Endoscopic submucosal dissection for superficial esophageal squamous cell neoplasms

Endoscopic submucosal dissection for superficial esophageal squamous cell neoplasms

Management of strictures after endoscopic submucosal dissection for superficial esophageal cancer

Laparoscopic and endoscopic cooperative surgery for gastrointestinal tumor

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