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DOI: 10.1055/a-1672-4122
Stepwise endoscopic submucosal dissection for circumferential Barrett’s esophageal dysplasia and carcinoma: a case series
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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.
Publikationsverlauf
Eingereicht: 19. Juni 2021
Angenommen: 17. September 2021
Artikel online veröffentlicht:
15. Februar 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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References
- 1 Hongo M, Nagasaki Y, Shoji T. Epidemiology of esophageal cancer: Orient to Occident. Effects of chronology, geography and ethnicity. J Gastroenterol Hepatol 2009; 24: 729-735
- 2 Koike T, Nakagawa K, Iijima K. et al. Endoscopic resection (endoscopic submucosal dissection/endoscopic mucosal resection) for superficial Barrettʼs esophageal cancer. Dig Endosc 2013; 25 (Suppl. 01) 20-28
- 3 Martelli MG, Duckworth LV, Draganov PV. Endoscopic submucosal dissection is superior to endoscopic mucosal resection for histologic evaluation of Barrettʼs esophagus and Barrettʼs-related neoplasia. Am J Gastroenterol 2016; 111: 902-903
- 4 Shimizu T, Fujisaki J, Omae M. et al. Treatment outcomes of endoscopic submucosal dissection for adenocarcinoma originating from long-segment Barrettʼs esophagus versus short-segment Barrettʼs esophagus. Digestion 2018; 97: 316-323
- 5 Iizuka T, Kikuchi D, Hoteya S. et al. Effectiveness of modified oral steroid administration for preventing esophageal stricture after entire circumferential endoscopic submucosal dissection. Dis Esophagus 2018; 31 DOI: 10.1093/dote/dox140.
- 6 Koike Y, Hirasawa D, Fujita N. et al. Usefulness of the thread-traction method in esophageal endoscopic submucosal dissection: randomized controlled trial. Dig Endosc 2015; 27: 303-309
- 7 Yamagata T, Hirasawa D, Fujita N. et al. Efficacy of acetic acid-spraying method in diagnosing extension of Barrettʼs cancer under the squamous epithelium. Dig Endosc 2012; 24: 309-314
- 8 Schlemper RJ, Riddell RH, Kato Y. et al. The Vienna classification of gastrointestinal epithelial neoplasia. Gut 2000; 47: 251-255
- 9 Miwata T, Oka S, Tanaka S. et al. Risk factors for esophageal stenosis after entire circumferential endoscopic submucosal dissection for superficial esophageal squamous cell carcinoma. Surg Endosc 2016; 30: 4049-4056
- 10 Peters FP, Kara MA, Rosmolen WD. et al. Stepwise radical endoscopic resection is effective for complete removal of Barrettʼs esophagus with early neoplasia: a prospective study. Am J Gastroenterol 2006; 101: 1449-1457
- 11 Shaheen NJ, Falk GW, Iyer PG. et al. ACG clinical guideline: diagnosis and management of Barrettʼs esophagus. Am J Gastroenterol 2016; 111: 30-50
- 12 Pimentel-Nunes P, Dinis-Ribeiro M, Ponchon T. et al. Endoscopic submucosal dissection: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2015; 47: 829-854
- 13 Pouw RE, Seewald S, Gondrie JJ. et al. Stepwise radical endoscopic resection for eradication of Barrettʼs oesophagus with early neoplasia in a cohort of 169 patients. Gut 2010; 59: 1169-1177
- 14 Titi M, Overhiser A, Ulusarac O. et al. Development of subsquamous high-grade dysplasia and adenocarcinoma after successful radiofrequency ablation of Barrettʼs esophagus. Gastroenterology 2012; 143: 564-566 e561