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KMID : 0338420160310061064
The Korean Journal of Internal Medicine
2016 Volume.31 No. 6 p.1064 ~ p.1072
Ten-year experience of esophageal endoscopic submucosal dissection of superficial esophageal neoplasms in a single center
Park Hyung-Chul

Kim Do-Hoon
Gong Eun-Jeong
Na Hee-Kyong
Ahn Ji-Yong
Lee Jeong-Hoon
Jung Kee-Wook
Choi Kee-Don
Song Ho-June
Lee Gin-Hyug
Jung Hwoon-Yong
Kim Jin-Ho
Abstract
Background/Aims: Endoscopic submucosal dissection (ESD) of a superficial esophageal neoplasm (SEN) is a technically difficult procedure. We investigated the clinical outcomes of ESD to determine its feasibility and effectiveness for the treatment of SEN.

Methods: Patients who underwent ESD for SEN between August 2005 and June 2014 were eligible for this study. The clinical features of patients and tumors, histopathologic characteristics, adverse events, results of endoscopic resection, and survival were investigated.

Results: ESD was performed in 225 patients with 261 lesions, including 70 cases (26.8%) of dysplasias and 191 cases (73.2%) of squamous cell carcinomas. The median age was 65 years (range, 44 to 86), and the male to female ratio was 21.5:1. Median tumor size was 37 mm (range, 5 to 85) and median procedure time was 45 minutes (range, 9 to 160). En bloc resection was performed in 245 of 261 lesions (93.9%), with complete resection in 234 lesions (89.7%) and curative resection in 201 lesions (77.0%). Adverse events occurred in 33 cases (12.6%), including bleeding (1.5%), perforation (4.6%), and stricture (6.5%). During a median follow-up period of 35.0 months (interquartile range, 18 to 62), none of the patients showed local recurrence. The 5-year overall and disease-specific survival rates were 89.7% and 100%, respectively.

Conclusions: ESD is a feasible and effective procedure for the treatment of SEN based on our 10-year experience, which showed favorable outcomes.
KEYWORD
Esophageal neoplasms, Endoscopic submucosal dissection, En bloc resection
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