Management of esophageal neoplasms by endoscopic submucosal dissection: experience over 100 consecutive procedures
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Background/Aims: Endoscopic submucosal dissection (ESD) is currently considered the first-line treatment for the eradication of superficialneoplasms of the esophagus in Eastern countries. However, in the West, particularly in Latin America, the experience withesophageal ESD is still limited because of the high technical complexity required for its execution. This study aimed to present the resultsof the clinical application of ESD to manage superficial esophageal neoplasms in a Latin American center in over 100 consecutivecases. Methods: This retrospective study included consecutive patients who underwent endoscopic ESD for superficial esophageal neoplasmsbetween 2009 and 2022. The following clinical outcomes were assessed: en bloc, complete, and curative resection rates, local recurrence,adverse events, and procedure-related mortality. Results: Esophageal ESD was performed mainly for squamous cell carcinoma (66.6%), high-grade intraepithelial neoplasia (17.1%),and adenocarcinoma (11.4%). En bloc and complete resection rates were 96.2% and 81.0%, respectively. The curative resection rate was64.8%. Adverse events occurred in six cases (5.7%). Endoscopic follow-up was performed for an average period of 29.7 months. Conclusions: ESD performed by trained operators is feasible, safe, and clinically effective for managing superficial neoplastic lesions ofthe esophagus in Latin America.
Abstract
Background/Aims: Endoscopic submucosal dissection (ESD) is currently considered the first-line treatment for the eradication of superficialneoplasms of the esophagus in Eastern countries. However, in the West, particularly in Latin America, the experience withesophageal ESD is still limited because of the high technical complexity required for its execution. This study aimed to present the resultsof the clinical application of ESD to manage superficial esophageal neoplasms in a Latin American center in over 100 consecutivecases. Methods: This retrospective study included consecutive patients who underwent endoscopic ESD for superficial esophageal neoplasmsbetween 2009 and 2022. The following clinical outcomes were assessed: en bloc, complete, and curative resection rates, local recurrence,adverse events, and procedure-related mortality. Results: Esophageal ESD was performed mainly for squamous cell carcinoma (66.6%), high-grade intraepithelial neoplasia (17.1%),and adenocarcinoma (11.4%). En bloc and complete resection rates were 96.2% and 81.0%, respectively. The curative resection rate was64.8%. Adverse events occurred in six cases (5.7%). Endoscopic follow-up was performed for an average period of 29.7 months. Conclusions: ESD performed by trained operators is feasible, safe, and clinically effective for managing superficial neoplastic lesions ofthe esophagus in Latin America.
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