Portal de Periódicos da CAPES

Comparison of EMR and endoscopic submucosal dissection for en bloc resection of early esophageal cancers in Japan

2008; Elsevier BV; Volume: 68; Issue: 6 Linguagem: Inglês

10.1016/j.gie.2008.03.1114

1097-6779

Ryu Ishihara, Hiroyasu Iishi, Noriya Uedo, Yoji Takeuchi, Sachiko Yamamoto, Takuya Yamada, Eriko Masuda, Koji Higashino, Motohiko Kato, Hiroyuki Narahara, Masaharu Tatsuta,

Metastasis and carcinoma case studies

Background EMR and endoscopic submucosal dissection (ESD) are now being increasingly used for the treatment of esophageal cancers. However, their efficacies in smaller lesions have not been compared. Objective For effective use of these methods, we compared the results of ESD and 2 major EMR methods for treating esophageal cancers of ≤20 mm. Design A retrospective study. Setting A cancer-referral center. Patients A total of 136 patients with 171 lesions ≤20 mm who presented between January 2002 and October 2007 were enrolled. Main Outcome Measurements En bloc and curative resection. Results Of the 171 lesions, 168 were squamous-cell carcinoma and 3 were adenocarcinoma. The en bloc resection rates decreased in the order of ESD (100%), EMR using a transparent cap (EMRC) (87%), and 2-channel EMR (71%). However, the differences showed only marginal significance. The curative resection rate of ESD (97%) was significantly higher than those of the other 2 methods. Furthermore, the curative resection rate of EMRC (71%) was significantly higher than that of 2-channel EMR (46%). In lesions <15 mm, the en bloc and curative resection rates were significantly higher for EMRC (100% and 86%, respectively) than 2-channel EMR (86% and 51%, respectively), whereas no significant differences were found between the en bloc and curative resection rates of EMRC and ESD. There were no differences in the complication rates. Limitations A single-center, retrospective analysis. Conclusions ESD was found to be the best endoscopic resection method, even for smaller esophageal cancers. EMRC would be a good alternative to ESD for lesions <15 mm. EMR and endoscopic submucosal dissection (ESD) are now being increasingly used for the treatment of esophageal cancers. However, their efficacies in smaller lesions have not been compared. For effective use of these methods, we compared the results of ESD and 2 major EMR methods for treating esophageal cancers of ≤20 mm. A retrospective study. A cancer-referral center. A total of 136 patients with 171 lesions ≤20 mm who presented between January 2002 and October 2007 were enrolled. En bloc and curative resection. Of the 171 lesions, 168 were squamous-cell carcinoma and 3 were adenocarcinoma. The en bloc resection rates decreased in the order of ESD (100%), EMR using a transparent cap (EMRC) (87%), and 2-channel EMR (71%). However, the differences showed only marginal significance. The curative resection rate of ESD (97%) was significantly higher than those of the other 2 methods. Furthermore, the curative resection rate of EMRC (71%) was significantly higher than that of 2-channel EMR (46%). In lesions <15 mm, the en bloc and curative resection rates were significantly higher for EMRC (100% and 86%, respectively) than 2-channel EMR (86% and 51%, respectively), whereas no significant differences were found between the en bloc and curative resection rates of EMRC and ESD. There were no differences in the complication rates. A single-center, retrospective analysis. ESD was found to be the best endoscopic resection method, even for smaller esophageal cancers. EMRC would be a good alternative to ESD for lesions <15 mm.