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Surgical Endoscopy
Erschienen in:

13.10.2022 | Dynamic Manuscript

High proficiency of esophageal endoscopic submucosal dissection with a "tunnel + clip traction" strategy: a large French multicentric study

verfasst von: Sophie Stephant, Jérémie Jacques, Charlène Brochard, Romain Legros, Hugo Lepetit, Maximilien Barret, Alexandru Lupu, Florian Rostain, Jérôme Rivory, Thierry Ponchon, Mathieu Pioche, Timothée Wallenhorst

Erschienen in: Surgical Endoscopy | Ausgabe 3/2023

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Abstract

Background

Esophageal endoscopic submucosal dissection (ESD) is the gold standard for the treatment of precancerous lesions or superficial esophageal cancers. This procedure is currently performed by expert endoscopists only, and poorly standardized. We aimed to assess the technical results and outcomes of a "tunnel + clip" strategy for esophageal ESD procedures performed by less experienced operators for the treatment of superficial neoplasms.

Methods

All consecutive esophageal ESDs performed with the “tunnel + clip” technique for patients with early esophageal cancer in 3 centers were enrolled. Procedural characteristics, clinical outcomes, and complications were recorded.

Results

Among 195 esophageal ESD procedures performed, early adenocarcinomas or high-grade dysplasia complicating Barrett’s esophagus were predominant (132/195, 67.7%) compared with early squamous cell carcinomas (63/195, 32.3%). The en bloc, R0 and curative resection rates were 100% (195/195), 78.5% (153/195) and 67.2% (131/195), respectively. The mean rate of ESD was 29.7 mm2/min. One (0.5%) perprocedural perforation and 7 (3.6%) postprocedural bleedings occurred, all managed endoscopically. No delayed perforation occurred. Overall, 31 patients (31/195; 15.9%) of patients developed stenosis.

Conclusions

The “tunnel + clip” strategy is safe, and allows to achieve high en bloc, R0 and curative resection rates. This standardized procedure could be used by physicians with little experience and might help spreading esophageal ESD in Western countries.
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Metadaten
Titel
High proficiency of esophageal endoscopic submucosal dissection with a "tunnel + clip traction" strategy: a large French multicentric study
verfasst von
Sophie Stephant
Jérémie Jacques
Charlène Brochard
Romain Legros
Hugo Lepetit
Maximilien Barret
Alexandru Lupu
Florian Rostain
Jérôme Rivory
Thierry Ponchon
Mathieu Pioche
Timothée Wallenhorst
Publikationsdatum
13.10.2022
Verlag
Springer US
Erschienen in
Surgical Endoscopy / Ausgabe 3/2023
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-022-09689-7

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