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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.
- 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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