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首页> 外文期刊>Endoscopy International Open >Clinical feasibility of endoscopic submucosal dissection with minimum lateral margin of superficial esophageal squamous cell carcinoma
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Clinical feasibility of endoscopic submucosal dissection with minimum lateral margin of superficial esophageal squamous cell carcinoma

机译：内镜下食管鳞状细胞癌最小侧缘黏膜下剥离术的临床可行性

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Background Esophageal stricture following endoscopic submucosal dissection (ESD) for superficial esophageal squamous cell cancer (SESCC) has been associated with wide mucosal defects greater than three-quarters of the luminal circumference. Some patients developed dysphagia and required repeated endoscopic balloon dilation even after steroid therapy. As iodine staining clearly visualized the margin of SESCC, we made a longitudinal mucosal incision close to the margin of the lesion to avoid a mucosal defect involving over three-quarters of the luminal circumference for large lesions. This retrospective study aimed to clarify the clinical feasibility of ESD with minimum lateral margin of SESCC. Patients and methods Between 2005 and 2013, 94 patients with 94 initial SESCCs had lesions greater than half of the luminal circumference. Of those, 70 patients with 70 SESCCs had achieved endoscopic clearance for the initial SESCC. In this study, endoscopic clearance was defined as en bloc resection of SESCC histologically confined to the mucosa without lymphovascular invasion and with a free deep margin regardless of the lateral margin. This study evaluated the short- and long-term outcomes in patients undergoing endoscopic clearance. Results In total, 61.4?% (43/70) of the patients had mucosal defects involving over three-quarters of the luminal circumference and 38.5?% (27/70) had a positive or indeterminate lateral margin. However, there was no local or nodal recurrence during the median follow-up period of 3.8 years; the 3-year overall survival rate was 98.5?% and the 3-year disease-free survival rate was 100?%. Conclusion Using our institutions’ strategy, ESD for SESCCs with minimum lateral margins was oncologically acceptable; this approach could reduce the known risk factor of post-ESD stricture.
机译：背景内镜下黏膜下剥离术（ESD）引起的食管狭窄是浅表食管鳞状细胞癌（SESCC）的原因，其广泛的粘膜缺损大于管腔周长的四分之三。有些患者出现吞咽困难，甚至在类固醇治疗后仍需要反复进行内镜下球囊扩张术。由于碘染色清楚地显示了SESCC的边缘，我们在靠近病变边缘的地方进行了纵向粘膜切开，以避免大面积病变的管腔周长超过四分之三。这项回顾性研究旨在阐明具有SESCC最小横向裕度的ESD的临床可行性。患者和方法2005年至2013年之间，94例具有94例初始SESCC的患者病灶大于腔周长的一半。在这些患者中，有70位SESCC的患者中有70位已通过初始SESCC的内镜清除。在这项研究中，内镜清除率定义为在组织学范围内将SESCC整块切除，局限于组织，无淋巴管浸润，且无明显深切缘，而与侧切缘无关。这项研究评估了接受内镜清除的患者的短期和长期结果。结果总共有61.4％（43/70）的患者出现粘膜缺损，占管腔周长的四分之三，而38.5％（27/70）的患者侧缘阳性或不确定。但是，在中位随访期3.8年内，没有局部或淋巴结复发。 3年总生存率为98.5％，3年无病生存率为100％。结论根据我们机构的策略，在肿瘤学上可接受最小侧向边缘的SESCC的ESD。这种方法可以减少ESD后狭窄的已知危险因素。

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