Endoscopic submucosal tunnel dissection for large esophageal neoplastic lesions

被引:50
作者
Pioche, Mathieu [1 ,2 ]
Mais, Laetitia [1 ]
Guillaud, Olivier [1 ]
Hervieu, Valerie [3 ]
Saurin, Jean-Christophe [1 ]
Ponchon, Thierry [1 ,2 ]
Lepilliez, Vincent [1 ]
机构
[1] Hosp Civils Lyon, Edouard Herriot Hosp, Gastroenterol & Endoscopy Unit, F-69437 Lyon, France
[2] INSERM, U1032, LabTau, F-69008 Lyon, France
[3] Hosp Civils Lyon, Edouard Herriot Hosp, Pathol Unit, F-69437 Lyon, France
关键词
EARLY GASTRIC-CANCER; MUCOSAL RESECTION; WESTERN;
D O I
10.1055/s-0033-1344855
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background and study aim: Endoscopic submucosal dissection (ESD) is recommended for en bloc R0 resection of superficial esophageal neoplasms larger than 20mm, but is high risk and time-consuming. In the tunnel technique, incisions at the lower and upper lesion edges are joined by a submucosal tunnel and then lateral incisions are made. The mucosa is thereby easily separated from the muscular layer. We report our experience of esophageal tunnel ESD. Patients and methods: We retrospectively reviewed all consecutive esophageal tunnel ESDs performed at our unit between January 1 2010 and January 11 2013.Lesions were superficial esophageal neoplasms, UT1N0at EUS. Results: 11 patients underwent tunnel ESD (nine squamous cell carcinomas, two adenocarcinomas). Mean dissected surface area was 13.25cm(2). Mean procedure duration was 76.7 minutes. All 11 resections were en bloc and 9/11 were R0.Complications were one subcutaneous emphysema with spontaneous resolution, and stenosis in 4/11 patients (36.4%) with resolution after 1-5 dilations. Conclusion: Tunnel ESD of superficial esophageal neoplasms is an interesting option, seeming to be faster and more effective than standard ESD, without higher morbidity.
引用
收藏
页码:1032 / 1034
页数:3
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