Clinical Endoscopy

  • 제56권5호
  • /
  • Pages.613-622
  • /
  • 2023
  • /
  • 2234-2400(pISSN)
  • /
  • 2234-2443(eISSN)
대한소화기내시경학회 (The Korean Society of Gastrointestinal Endoscopy)
권호 표지
DOI QR코드

DOI QR Code

Management of esophageal neoplasms by endoscopic submucosal dissection: experience over 100 consecutive procedures

  • Josue Aliaga Ramos (Department of Gastroenterology, ) ;
  • Yoshinori Morita (Department of Gastroenterology, Kobe University International Clinical Cancer Reserch Center) ;
  • Takashi Toyonaga (Department of Gastroenterology, Kobe University International Clinical Cancer Reserch Center) ;
  • Danilo Carvalho (Endoscopy Unit, Alfa Institute of Gastroenterology) ;
  • Moises Salgado Pedrosa (Pathology Department, Alfa Institute of Gastroenterology, School of Medicine, Federal University of Minas Gerais, Laboratorio CEAP) ;
  • Vitor N. Arantes (Endoscopy Unit, Alfa Institute of Gastroenterology, School of Medicine, Federal University of Minas Gerais, Hospital Mater Dei Contorno)
  • 투고 : 2022.09.01
  • 심사 : 2022.11.14
  • 발행 : 2023.09.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Background/Aims: Endoscopic submucosal dissection (ESD) is currently considered the first-line treatment for the eradication of superficial neoplasms of the esophagus in Eastern countries. However, in the West, particularly in Latin America, the experience with esophageal ESD is still limited because of the high technical complexity required for its execution. This study aimed to present the results of the clinical application of ESD to manage superficial esophageal neoplasms in a Latin American center in over 100 consecutive cases. Methods: This retrospective study included consecutive patients who underwent endoscopic ESD for superficial esophageal neoplasms between 2009 and 2022. The following clinical outcomes were assessed: en bloc, complete, and curative resection rates, local recurrence, adverse events, and procedure-related mortality. Results: Esophageal ESD was performed mainly for squamous cell carcinoma (66.6%), high-grade intraepithelial neoplasia (17.1%), and adenocarcinoma (11.4%). En bloc and complete resection rates were 96.2% and 81.0%, respectively. The curative resection rate was 64.8%. Adverse events occurred in six cases (5.7%). Endoscopic follow-up was performed for an average period of 29.7 months. Conclusions: ESD performed by trained operators is feasible, safe, and clinically effective for managing superficial neoplastic lesions of the esophagus in Latin America.

키워드

과제정보

We gratefully acknowledge the staff at the Department of Gastroenterology, Kobe University and International Clinical Cancer Research Center, Kobe, Japan for their participation and for making this study possible.

참고문헌

  1. Arnold M, Soerjomataram I, Ferlay J, et al. Global incidence of oesophageal cancer by histological subtype in 2012. Gut 2015;64:381-387.
  2. Pimentel-Nunes P, Libanio D, Bastiaansen BA, et al. Endoscopic submucosal dissection for superficial gastrointestinal lesions: European Society of Gastrointestinal Endoscopy (ESGE) Guideline: update 2022. Endoscopy 2022;54:591-622.
  3. Matsueda K, Ishihara R. Preoperative diagnosis and indications for endoscopic resection of superficial esophageal squamous cell carcinoma. J Clin Med 2020;10:13.
  4. Aliaga Ramos J, Arantes V, Abdul Rani R, et al. Off-label use of 0.4% sodium hyaluronate teardrops: a safe and effective solution for submucosal injection in gastric endoscopic submucosal dissection. Endosc Int Open 2020;8:E1741-E1747.
  5. Kawata N, Tanaka M, Kakushima N, et al. The low incidence of bacteremia after esophageal endoscopic submucosal dissection (ESD) obviates the need for prophylactic antibiotics in esophageal ESD. Surg Endosc 2016;30:5084-5090.
  6. Arantes V, Aliaga Ramos J, Richard White J, Parra-Blanco A. Clinical effectiveness of short course oral prednisone for stricture prevention after semi circumferential esophageal endoscopic submucosal dissection. Endosc Int Open 2022;10:E753-E761.
  7. Kim SJ, Kim GH, Lee MW, et al. New magnifying endoscopic classification for superficial esophageal squamous cell carcinoma. World J Gastroenterol 2017;23:4416-4421.
  8. Ishihara R, Arima M, Iizuka T, et al. Endoscopic submucosal dissection/endoscopic mucosal resection guidelines for esophageal cancer. Dig Endosc 2020;32:452-493.
  9. Kitagawa Y, Uno T, Oyama T, et al. Esophageal cancer practice guidelines 2017 edited by the Japan Esophageal Society: part 1. Esophagus 2019;16:1-24.
  10. Kitagawa Y, Uno T, Oyama T, et al. Esophageal cancer practice guidelines 2017 edited by the Japan esophageal society: part 2. Esophagus 2019;16:25-43.
  11. Suzuki T, Furukawa K, Funasaka K, et al. Long-term prognostic predictors of esophageal squamous cell carcinoma potentially indicated for endoscopic submucosal dissection. Digestion 2021;102:563-571.
  12. Mizumoto T, Hiyama T, Oka S, et al. Diagnosis of superficial esophageal squamous cell carcinoma invasion depth before endoscopic submucosal dissection. Dis Esophagus 2018;31:dox142.
  13. Oyama T, Inoue H, Arima M, et al. Prediction of the invasion depth of superficial squamous cell carcinoma based on microvessel morphology: magnifying endoscopic classification of the Japan Esophageal Society. Esophagus 2017;14:105-112.
  14. Sgourakis G, Gockel I, Lang H. Endoscopic and surgical resection of T1a/T1b esophageal neoplasms: a systematic review. World J Gastroenterol 2013;19:1424-1437.
  15. Kawashima K, Abe S, Koga M, et al. Optimal selection of endoscopic resection in patients with esophageal squamous cell carcinoma: endoscopic mucosal resection versus endoscopic submucosal dissection according to lesion size. Dis Esophagus 2021;34:doaa096.
  16. Min YW, Lee H, Song BG, et al. Comparison of endoscopic submucosal dissection and surgery for superficial esophageal squamous cell carcinoma: a propensity score-matched analysis. Gastrointest Endosc 2018;88:624-633.
  17. Tsou YK, Chuang WY, Liu CY, et al. Learning curve for endoscopic submucosal dissection of esophageal neoplasms. Dis Esophagus 2016;29:544-550.
  18. Berger A, Rahmi G, Perrod G, et al. Long-term follow-up after endoscopic resection for superficial esophageal squamous cell carcinoma: a multicenter Western study. Endoscopy 2019;51:298-306.
  19. Lorenzo D, Barret M, Leblanc S, et al. Outcomes of endoscopic submucosal dissection for early oesophageal squamous cell neoplasia at a Western centre. United European Gastroenterol J 2019;7:1084-1092.
  20. Repici A, Hassan C, Carlino A, et al. Endoscopic submucosal dissection in patients with early esophageal squamous cell carcinoma: results from a prospective Western series. Gastrointest Endosc 2010;71:715-721.
  21. Arantes V, Albuquerque W, Freitas Dias CA, et al. Standardized endoscopic submucosal tunnel dissection for management of early esophageal tumors (with video). Gastrointest Endosc 2013;78:946-952.
  22. Xu W, Liu XB, Li SB, et al. Prediction of lymph node metastasis in superficial esophageal squamous cell carcinoma in Asia: a systematic review and meta-analysis. Dis Esophagus 2020;33:doaa032.
  23. Ye B, Zhang X, Su Y, et al. The possibility of endoscopic treatment of cN0 submucosal esophageal cancer: results from a surgical cohort. Surg Endosc 2021;35:593-601.
  24. Manner H, Pech O, Heldmann Y, et al. The frequency of lymph node metastasis in early-stage adenocarcinoma of the esophagus with incipient submucosal invasion (pT1b sm1) depending on histological risk patterns. Surg Endosc 2015;29:1888-1896.
  25. Ribeiro TM, Arantes VN, Ramos JA, et al. Endoscopic submucosal dissection with circumferential incision versus tunneling method for treatment of superficial esophageal cancer. Arq Gastroenterol 2021;58:195-201.
  26. Furue Y, Katada C, Tanabe S, et al. Effectiveness and safety of endoscopic aspiration mucosectomy and endoscopic submucosal dissection in patients with superficial esophageal squamous-cell carcinoma. Surg Endosc 2019;33:1433-1440.
  27. Tsujii Y, Nishida T, Nishiyama O, et al. Clinical outcomes of endoscopic submucosal dissection for superficial esophageal neoplasms: a multicenter retrospective cohort study. Endoscopy 2015;47:775-783.
  28. Yamashina T, Ishihara R, Uedo N, et al. Safety and curative ability of endoscopic submucosal dissection for superficial esophageal cancers at least 50 mm in diameter. Dig Endosc 2012;24:220-225.
  29. Park JS, Youn YH, Park JJ, et al. Clinical outcomes of endoscopic submucosal dissection for superficial esophageal squamous neoplasms. Clin Endosc 2016;49:168-175.