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CC BY-NC-ND 4.0 · Endosc Int Open 2022; 10(02): E215-E221
DOI: 10.1055/a-1672-4122
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Stepwise endoscopic submucosal dissection for circumferential Barrett’s esophageal dysplasia and carcinoma: a case series

Ippei Tanaka
1   Department of Gastroenterology, Sendai Kousei Hospital, Sendai-city, Miyagi, Japan
,
Dai Hirasawa
1   Department of Gastroenterology, Sendai Kousei Hospital, Sendai-city, Miyagi, Japan
,
Hiroaki Saito
1   Department of Gastroenterology, Sendai Kousei Hospital, Sendai-city, Miyagi, Japan
,
Junichi Akahira
2   Department of Pathology, Sendai Kousei Hospital, Sendai-city, Miyagi, Japan
,
Fumiyoshi Fujishima
3   Department of Anatomic Pathology, Tohoku University School of Medicine, Sendai-city, Japan
,
Tomoki Matsuda
1   Department of Gastroenterology, Sendai Kousei Hospital, Sendai-city, Miyagi, Japan
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The incidence of neoplasia developing in long-segment Barrett’s esophagus (LSBE) has recently been gradually increasing in Japan. These neoplastic lesions are sometimes detected as circumferential lesions. However, if such lesions are removed with circumferential en bloc resection by endoscopic submucosal dissection (ESD), severe postoperative stenosis is inevitable. Therefore, we performed stepwise ESD in three patients with circumferential LSBE dysplasia or intramucosal carcinoma. The entire Barrett’s neoplasia was successfully resected in all three patients. No adverse events such as posterior bleeding or perforation were observed. Only one patient experienced mild postoperative stenosis, which was resolved with a single balloon dilation. The pathological diagnosis of the lesions was high-grade dysplasia or intramucosal carcinoma. No recurrence was observed in any patient during an average follow-up of 20 months. In conclusion, stepwise ESD may be an effective and safe treatment for circumferential Barrettʼs neoplasia.



Publication History

Received: 19 June 2021

Accepted: 17 September 2021

Article published online:
15 February 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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Comment to this article:

Endoscopy International Open – recently publishedEndoscopy 2022; 54(03): 340-340
DOI: 10.1055/a-1683-0942

 

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