Stepwise endoscopic submucosal dissection for circumferential Barrett’s esophageal dysplasia and carcinoma: a case series

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.

Publikationsverlauf

Eingereicht: 19. Juni 2021

Angenommen: 17. September 2021

Artikel online veröffentlicht:
15. Februar 2022

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