Single center experience of endoscopic submucosal dissection (ESD) in early Barrett´s adenocarcinoma View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2014-10-08

AUTHORS

S. Höbel, P. Dautel, R. Baumbach, K.-J. Oldhafer, A. Stang, B. Feyerabend, N. Yahagi, C. Schrader, S. Faiss

ABSTRACT

BackgroundEndoscopic mucosal resection (EMR) or radical surgical resection are the standard treatment options for patients with early Barrett´s adenocarcinoma (EBAC). Endoscopic submucosal dissection (ESD) is a new endoscopic technique, which allows—in contrast to EMR—endoscopic en-bloc resection of neoplastic lesions greater than 2 cm with complete histological evaluation of the resected specimen. In contrast to Western countries, Barrett´s esophagus is less common in Asia indicating the low volume of published data of ESD in EBAC in Japanese series. Therefore, the aim of the present study is to describe the results of ESD in patients with EBAC performed in a German tertiary referral center. MethodsBetween November 2009 and April 2014 ESDs were performed in 22 patients with histologically proven EBAC. Data were given for the en-bloc, the R0, the R0 en-bloc, and the curative resection rate as well as for the complication and the local recurrence rate.ResultsESD was technically possible in all of the 22 patients. 20 of the resected EBAC were mucosal carcinomas, whereas in two patients the tumor showed submucosal invasion. The en-bloc, R0, R0 en-bloc, and curative resection rates were 95.5, 81.8, 81.8 %, and77.3 %, resp. Complication rate was 27.3 % (perforation n = 1, bleeding n = 2, stenosis n = 3). In case of curative tumor resection, only one local tumor recurrence (5.9 %) occurred after a medium follow-up of 1.6 years.ConclusionsDespite the small number of patients and a relatively short follow-up, the present data underline the value of ESD, especially in case of curative resections in the definite and less invasive therapy of EBAC. Attention should be drawn toward subsquamous extension of EBAC requiring a sufficient safety margin as an obligate condition for curative R0 resections. Due to the required learning curve and the management of potential complications, ESD should be restricted to greater endoscopic centers. More... »

PAGES

1591-1597

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00464-014-3847-5

DOI

http://dx.doi.org/10.1007/s00464-014-3847-5

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1032370884

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/25294533


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97 radical surgical resection
98 rate
99 recurrence
100 recurrence rate
101 referral center
102 resection
103 resection rate
104 resp
105 results
106 results of ESD
107 safety margin
108 series
109 single-center experience
110 small number
111 specimen
112 standard treatment option
113 study
114 submucosal dissection
115 submucosal invasion
116 subsquamous extension
117 sufficient safety margin
118 surgical resection
119 technique
120 tertiary referral center
121 therapy
122 treatment options
123 tumor recurrence
124 tumor resection
125 tumors
126 value of ESD
127 values
128 volume
129 years
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