Background:
Treatment of local recurrent or residual superficial esophageal squamous-cell carcinoma (scc) with conventional emr often results in a piecemeal resection that requires further intervention.
Objective:
The aim of this study was to evaluate the efficacy of endoscopic submucosal dissection (esd).
Design:
A case series.
Patients:
Between january 2006 and september 2006, 4 local recurrent or residual superficial esophageal sccs were treated by esd.
Interventions:
Esd procedures were performed by using a bipolar needle knife and an insulation-tipped knife. after injection of glycerol into the submucosal (sm) layer, a circumferential incision was made, and an sm dissection was performed. all lesions were determined to be intramucosal or sm superficial, without lymph-node metastasis by eus before treatment.
Main outcome measurements:
Tumor size, en bloc resection rate, tumor-free lateral margin rates, and complications were recorded.
Results:
All 4 esd cases were successfully resected en bloc, and the tumor-free lateral margin rate was 75% (3/4) by histopathology examination. the mean tumor size of the resected specimens was 35 mm (range, 15-50 mm). there were no complications.
Limitations:
The number of esds in our series was limited, and there are no long-term follow-up data.
Conclusions:
Esd for recurrent or residual superficial esophageal tumors after chemoradiotherapy achieves the goal of an en bloc resection, with a low rate of incomplete treatment without any greater risk than the emr technique.