Preinjection With Ligation-Assisted Endoscopic Mucosal Resection for Barrett's Dysplasia and Early Esophageal Adenocarcinoma: Characteristic Histological Features of the Depth of Resection.

Autor:	Williams TJ; Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Australia.; School of Medicine, University of Queensland, Brisbane, Australia., Hlaing P; Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Australia.; School of Medicine, University of Queensland, Brisbane, Australia., Maher AM; Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Australia.; School of Medicine, University of Queensland, Brisbane, Australia., Walker N; Envoi Pathology., Kendall BJ; Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Australia.; School of Medicine, University of Queensland, Brisbane, Australia.; Gallipoli Medical Research Foundation, Greenslopes Private Hospital, Brisbane, Australia., Holtmann G; Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Australia.; School of Medicine, University of Queensland, Brisbane, Australia., Hourigan LF; Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Australia.; School of Medicine, University of Queensland, Brisbane, Australia.; Gallipoli Medical Research Foundation, Greenslopes Private Hospital, Brisbane, Australia.
Jazyk:	angličtina
Zdroj:	Journal of clinical gastroenterology [J Clin Gastroenterol] 2024 Jul 16. Date of Electronic Publication: 2024 Jul 16.
DOI:	10.1097/MCG.0000000000002026
Abstrakt:	Background and Aim: Endoscopic mucosal resection (EMR) is an established technique for the diagnosis and treatment of high-grade dysplasia (HGD) and early esophageal adenocarcinoma (EAC) in Barrett's esophagus. Submucosal preinjection is not universally used or generally recommended when performing routine ligation-assisted EMR. Prior studies, however, have demonstrated evidence of at least superficial muscle injury on ligation-assisted EMR without submucosal injection. There are limited published data supporting any potential benefit of submucosal preinjection. Our aim was to review this technique and determine the rate of any degree of muscle injury in patients with Barrett's HGD and EAC treated with submucosal preinjection before ligation-assisted EMR. Methods: Patients undergoing submucosal preinjection before ligation-assisted EMR for Barrett's esophagus at a single institution between 2012 and 2016 were identified. Data were collected regarding patient demographics and medical history, endoscopy and histopathology findings, adverse events, and subsequent outcomes. All EMR specimens were reviewed by an expert gastrointestinal pathologist. Results: One hundred fifty consecutive EMR procedures were performed on 70 patients. Of 70 patients, 85.7% of patients were men, with a median age of 68 years. EAC was identified in 75 specimens (50%) and HGD in 44 specimens (29.3%). Deep resection margins were clear of adenocarcinoma in all specimens. Muscularis propria was not identified in any of the 150 specimens. There were no cases of post-EMR perforation. Conclusions: Preinjection before ligation-assisted EMR achieved complete excision with histologically clear margins, without histological evidence of any inadvertent muscularis propria. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu