Tu1259 ESD for Early Esophageal Cancer at a Western Center: Practice Makes Perfect

Stavropoulos, Stavros N.; Gurram, Krishna C.; Bhumi, Sriya; Ly, Erin K.; Modayil, Rani J.; Munigala, Satish; Peller, Abraham; Friedel, David

doi:10.1016/j.gie.2017.03.1397

Cited by 3 publications

(3 citation statements)

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“…Our center’s resection experience with resection of cancer (EAC and SCC) and HGD yielded an en-bloc , R0, curative and stricture rate of 98%, 83%, 74% and 10% respectively (Figure 1 ). There was a significant decrease in procedure time with experience[ 15 ].…”

Section: Barrett’s Esophagus and Cancermentioning

confidence: 99%

Introduction of endoscopic submucosal dissection in the West

Friedel¹,

Stavropoulos²

2018

WJGE

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Endoscopic submucosal dissection (ESD) is well established in Asia as a modality for selected advanced lesions of both the upper and lower gastrointestinal tract, but ESD has not attained the same niche in the West due to a variety of reasons. These include competition from traditional surgery, minimally invasive surgery and endoscopic mucosal resection. Other obstacles to ESD introduction in the West include time commitment for learning and doing procedures, a steep learning curve, special equipment, lack of mentors, cost issues, interdisciplinary conflicts, concern regarding complications and lack of support from institutions and interfacing departments. There are intrinsic differences in pathology prevalence (e.g., early gastric cancer) between the two regions that are less conducive for ESD implementation in the West. We will elaborate on these issues and suggest measures as well as a protocol to overcome these obstacles and hopefully allow introduction of ESD as a tenable option for appropriate patients.

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Section: Barrett’s Esophagus and Cancermentioning

confidence: 99%

Introduction of endoscopic submucosal dissection in the West

Friedel¹,

Stavropoulos²

2018

WJGE

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“…There are many traditional examination methods for diagnosing esophageal cancer, including esophageal mucosal cytology and fibro-esophageal endoscopy. However, long-term studies have confirmed that such examinations can cause varying degrees of trauma, making them less acceptable to patients (12,13). At present, the primary clinical diagnostic methods for esophageal cancer are MSCT and X-ray barium meal.…”

Section: Discussionmentioning

confidence: 99%

Imaging characteristics of esophageal cancer in multi-slice spiral CT and barium meal radiography and their early diagnostic value

Wang¹,

Tang²,

Lin³

et al. 2022

J Gastrointest Oncol

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Background: To explore the imaging characteristics of esophageal cancer in multi-slice spiral CT (MSCT) and barium meal radiography and to analyze the value of the two examinations alone or in combination for cancer staging diagnosis. Methods:The clinical data of 87 patients with esophageal cancer admitted to our hospital from June 2018 to June 2020 were retrospectively analyzed. According to the different examination methods, they were divided into a barium meal group (n=28 cases, X-ray barium meal radiography), an MSCT group (n=29 cases, MSCT examination), and a combined group (n=30 cases, barium meal + MSCT). The imaging characteristics from the barium meal radiography and MSCT alone versus their combined results were compared with the pathological examination results to analyze their accuracy in diagnosing esophageal cancer staging.Results: Of the 87 cases, the esophageal cancer lesion sites were as follows: 23 cervical cases, 20 upper thoracic cases, 21 middle thoracic cases, and 23 lower thoracic cases. The X-ray barium meal examination of esophageal mucosa showed irregular filling of the esophagus. The esophageal wall was stiff or jagged, the lumen was narrow, and it was difficult for the barium to pass, the mucosa was discontinuous. The CT scan showed irregular thickening of the esophageal wall, eccentric and concentric stenosis of the esophageal cavity, and the upper part of the esophagus showed different degrees of expansion. The trachea and bronchi were invaded, deformed, and displaced under compression. The diagnostic staging results of the barium meal group and MSCT group were inconsistent with the pathological results (Kappa =0.105, 0.112; P>0.05). The diagnostic staging results of the combined group were in good agreement with the pathological results (Kappa =0.769). In addition, the accuracy of the combined group in the diagnosis of stage III-IV esophageal cancer among the three groups was significantly higher than that of the barium meal group and MSCT group alone (P<0.05).Conclusions: MSCT and barium meal radiography clearly display the imaging features of esophageal cancer and can provide reliable imaging evidence for preoperative diagnosis; the combination of both measures can effectively improve the accuracy of early diagnosis for esophageal cancer.

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“…In a multicenter study that was published in 2017, ESD for treatment of HGD or esophageal adenocarcinoma had a R0 resection, curative and stricture rate of 76%, 70% and 15% (22), respectively. Another study showed a stricture rate of 10% post ESD (23).…”

Section: Safety and Efficacymentioning

confidence: 95%

Advances in endoscopic resection: a review of endoscopic submucosal dissection (ESD), endoscopic full thickness resection (EFTR) and submucosal tunneling endoscopic resection (STER)

Dalal¹,

Andalib²

2021

Transl Gastroenterol Hepatol

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Subepithelial lesions are often detected incidentally in patients undergoing an endoscopy. They are common tumors of the gastrointestinal (GI) tract which can originate from different layers of the GI tract wall. These lesions can be further classified based on GI layer of origin and unique histochemical staining. While most are benign and asymptomatic, some of these lesions have malignant potential with distant metastases. However, current diagnostic modalities including endoscopy with biopsy or endoscopic ultrasound with fine needle aspiration are not always reliable. In addition, management of these lesions has historically involved surgical resection via open or laparoscopic approaches. In recent years, with advancement in endoscopic techniques and improvement in endoscopists' skills, less invasive procedures such as endoscopic submucosal dissection (ESD), endoscopic full thickness resection (EFTR) and submucosal tunneling endoscopic resection (STER) have been developed and now are being used by endoscopists worldwide. Upon reviewing the literature, multiple studies have shown the advantages of these endoscopic techniques when compared with surgical treatment. As a result, there has been a dramatic shift towards minimally invasive endoscopic procedures for the management of these subepithelial lesions. In this review article, we will discuss these endoscopic resection techniques in detail, their safety and efficacy, as well as comparison studies to other therapeutic modalities.

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Tu1259 ESD for Early Esophageal Cancer at a Western Center: Practice Makes Perfect

Cited by 3 publications

References 0 publications

Introduction of endoscopic submucosal dissection in the West

Introduction of endoscopic submucosal dissection in the West

Imaging characteristics of esophageal cancer in multi-slice spiral CT and barium meal radiography and their early diagnostic value

Advances in endoscopic resection: a review of endoscopic submucosal dissection (ESD), endoscopic full thickness resection (EFTR) and submucosal tunneling endoscopic resection (STER)

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