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Endoscopic submucosal dissection with a combination of small-caliber-tip transparent hood and flex knife is a safe and effective treatment for superficial esophageal neoplasias
Surgical Endoscopy, 06/15/09

Ishii N et al. - In a study to evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) for superficial esophageal neoplasias, it was concluded that ESD, with a combination of small-caliber-tip transparent hood and flex knife, is a safe endoscopic treatment for superficial esophageal neoplasias and enables large en bloc resection.

Methods

37 superficial esophageal neoplasias consisted of 34 squamous cell neoplasias and 3 columnar neoplasias in 35 pts were treated with ESD.
Pts were regularly followed up with endoscopy every 6 mos, and with echoendoscope and computed tomography every yr.
Therapeutic efficacy, complications, and follow-up results were evaluated.

Results

Mean size of the resected neoplasias and that of the resected specimens were 22 mm and 41 mm, respectively.
Mean duration of the ESD procedures was 117 min.
Overall rates of en bloc resection and of free margin resection were 100% (37/37) and 95% (35/37), respectively.
Mean follow-up period of 19 mos revealed no local or distant recurrence.
There were no complications such as bleeding or perforation in any case.
In all 9 cases, the strictures were successfully managed with prophylactic endoscopic balloon dilation.

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