Original articleEndoscopic Submucosal Dissection of Esophageal Squamous Cell Neoplasms
Section snippets
Patients and Methods
Fifty-eight consecutive superficial esophageal SCNs occurring in 43 patients were resected by ESD between January 2002 and September 2005 at the University of Tokyo Hospital, Tokyo, Japan. All patients with esophageal neoplasm who had a preoperative diagnosis of high-grade intraepithelial neoplasm (high-grade dysplasia and noninvasive carcinoma) or intramucosal invasive carcinoma were candidates for ESD. Diagnosis was made by using chromoendoscopy with iodine staining, endoscopic biopsy, and
Results
The clinicopathologic features of the included patients are shown in Table 1. All the lesions were resected in an en bloc fashion. En bloc resection with tumor-free lateral/basal margins (R0 resection) was accomplished in 45 of the 58 dissected lesions (78%) (Table 2). The mean resection size was 38 mm (range, 11–72 mm), and the mean lesion size was 24 mm (range, 2–66 mm). The small lesions for which conventional EMR seemed to be applicable in terms of lesion size were treated by ESD because of
Discussion
To show the efficacy of the ESD procedure for esophageal SCNs, 2 aspects, the technical feasibility of the procedure and follow-up data showing the efficacy of the procedure, have to be considered. Although the duration of follow-up is short, the present study shows that no patient with esophageal SCNs that met the criteria of node-negative tumors postoperatively treated with ESD experienced recurrence extraluminally. One noninvasive carcinoma with Rx (lateral) resection recurred locally in the
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