Endoscopic submucosal tunnel dissection for large superficial esophageal squamous cell neoplasms

被引:41
作者
Zhai, Ya-Qi [1 ]
Li, Hui-Kai [1 ]
Linghu, En-Qiang [1 ]
机构
[1] Chinese Peoples Liberat Army Gen Hosp, Dept Gastroenterol & Hepatol, Beijing 100853, Peoples R China
基金
中国国家自然科学基金;
关键词
Endoscopic submucosal tunnel dissection; Esophageal squamous cell neoplasms; Digestive endoscopic tunnel technique; Endoscopic submucosal dissection; POSTOPERATIVE STRICTURE; RESECTION; MANAGEMENT; DEVICE; EFFICACY; TUMORS; COMPLICATIONS; PERFORATIONS; FEASIBILITY; PREVENTION;
D O I
10.3748/wjg.v22.i1.435
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Endoscopic submucosal dissection (ESD) is a well-established treatment for superficial esophageal squamous cell neoplasms (SESCNs) with no risk of lymphatic metastasis. However, for large SESCNs, especially when exceeding two-thirds of the esophageal circumference, conventional ESD is time-consuming and has an increased risk of adverse events. Based on the submucosal tunnel conception, endoscopic submucosal tunnel dissection (ESTD) was first introduced by us to remove large SESCNs, with excellent results. Studies from different centers also reported favorable results. Compared with conventional ESD, ESTD has a more rapid dissection speed and R0 resection rate. Currently in China, ESTD for large SESCNs is an important part of the digestive endoscopic tunnel technique, as is peroral endoscopic myotomy for achalasia and submucosal tunnel endoscopic resection for submucosal tumors of the muscularis propria. However, not all patients with SESCNs are candidates for ESTD, and postoperative esophageal strictures should also be taken into consideration, especially for lesions with a circumference greater than three-quarters. In this article, we describe our experience, review the literature of ESTD, and provide detailed information on indications, standard procedures, outcomes, and complications of ESTD.
引用
收藏
页码:435 / 445
页数:11
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