Wide-field endoscopic submucosal dissection for the treatment of Barrett's esophagus neoplasia
| Autor: | Nelson Ndegwa, Michael Vieth, Miroslav Vujasinovic, Hannes Hagström, Naining Wang, Masami Omae, Francisco Baldaque-Silva |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Original article business.industry En bloc resection Endoscopic submucosal dissection RC799-869 Diseases of the digestive system. Gastroenterology medicine.disease Wide field Lateral margin Dissection medicine.anatomical_structure Barrett's esophagus medicine Pharmacology (medical) Radiology Esophagus business Cohort study |
| Zdroj: | Endoscopy International Open Endoscopy International Open, Vol 09, Iss 05, Pp E727-E734 (2021) |
| ISSN: | 2364-3722 |
| Popis: | Background and study aims Implementation of endoscopic submucosal dissection (ESD) for the treatment of Barrett’s esophagus neoplasia (BEN) has been hampered by high rates of positive margins and complications. Dissection with wider margins was proposed to overcome these problems, but was never tested. We aim to compare Wide-Field ESD (WF-ESD) with conventional ESD (C-ESD) for treatment of BEN. Patients and methods This was a cohort study of all ESDs performed in our center during 2011 to 2018. C-ESD was the only technique used before 2014, with WF-ESD used beginning in 2014. In WF-ESD marking was performed 10 mm from the tumor margin compared to 5 mm with C-E. Results ESD was performed in 90 cases, corresponding to 74 patients, 84 % male, median age 69. Of these, 22 were C-ESD (24 %) and 68 were WF-ESD (76 %). The en bloc resection rate was 95 vs 100 % (ns), the positive lateral margin rate was 23 % vs 3 % (P 0.05). The procedure speed was 4.4 and 2.3 (min/mm) in the C-ESD and WF-ESD groups (P Conclusions WF-ESD is associated with a reduction in positive lateral margins, faster dissection, and lower stricture rates. Further prospective, multicenter studies are warranted to evaluate its role in clinical practice. |
| Databáze: | OpenAIRE |
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