Clinical Endoscopy

  • 제55권3호
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  • Pages.381-389
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  • 2022
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  • 2234-2400(pISSN)
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  • 2234-2443(eISSN)
대한소화기내시경학회 (The Korean Society of Gastrointestinal Endoscopy)
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Outcomes of endoscopic submucosal dissection for superficial esophageal neoplasms in patients with liver cirrhosis

  • Young Kwon Choi (Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Jin Hee Noh (Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Do Hoon Kim (Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Hee Kyong Na (Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Ji Yong Ahn (Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Jeong Hoon Lee (Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kee Wook Jung (Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kee Don Choi (Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Ho June Song (Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Gin Hyug Lee (Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Hwoon-Yong Jung (Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine)
  • 투고 : 2021.09.27
  • 심사 : 2022.01.10
  • 발행 : 2022.05.30
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초록

Background/Aims: The treatment of superficial esophageal neoplasms (SENs) in cirrhotic patients is challenging and rarely investigated. We evaluated the outcomes of endoscopic submucosal dissection (ESD) to determine the efficacy and safety of treating SENs in patients with liver cirrhosis. Methods: The baseline characteristics and treatment outcomes of patients who underwent ESD for SENs between November 2005 and December 2017 were retrospectively reviewed. Results: ESD was performed in 437 patients with 481 SENs, including 15 cirrhotic patients with 17 SENs. En bloc resection (88.2% vs. 97.0%) and curative resection (64.7% vs. 78.9%) rates were not different between the cirrhosis and non-cirrhosis groups (p=0.105 and p=0.224, respectively). Bleeding was more common in cirrhotic patients (p=0.054), and all cases were successfully controlled endoscopically. The median procedure and hospitalization duration did not differ between the groups. Overall survival was lower in cirrhotic patients (p=0.003), while disease-specific survival did not differ between the groups (p=0.85). Conclusions: ESD could be a safe and effective treatment option for SENs in patients with cirrhosis. Detailed preprocedural assessments are needed, including determination of liver function, esophageal varix status, and remaining life expectancy, to identify patients who will obtain the greatest benefit.

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참고문헌

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