Objectives: Organ-sparing endoscopic submucosal dissection (ESD) is an acceptable treatment strategy for superficial neoplastic lesions of the esophagus and stomach. The adoption of this technique has lagged in North America compared with Asia, and we sought to report on our experiences with ESD for upper GI neoplasia.
Methods: A prospectively entered database of all patients undergoing endoscopic resection of esophageal and gastric neoplasia at McGill University from 2009 to 2019 was queried for those who received ESD.
Results: A total of 103 consecutive ESDs were identified from 2009 to 2019. Seventy-one (69%) patients were male and the median age was 72 (range: 38-90). Sixty-one (59%) cases were esophageal and 42 (41%) gastric. Forty-nine (48%) were performed in the endoscopy suite under local sedation only. Perforation occurred in 9 patients (7 esophageal and 2 stomach), of which 3 required operative repair. Histology was principally invasive carcinoma (79, 77%), with 17 (16%) dysplastic lesions (e.g., HGD), 1 (1%) neuroendocrine tumor, and 7 (7%) benign lesions. En bloc resection was achieved in 90 (87%), and the complete resection rate was 74 (72%), with 51 (50%) of procedures fulfilling the criteria for curative resection. At medium of 23-month (2-199) follow-up of these 51 curative resections, one case of recurrent carcinoma was found at follow-up and was managed with repeat endoscopic resection. Non-curative ESDs were found 45 (R1 resection = 29: risk of lymph node metastasis = 16), 21 had active surveillance, and 24 were resected.
Conclusion: ESD is a viable, effective, and safe therapeutic and staging modality for superficial lesions of the stomach and esophagus.
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http://dx.doi.org/10.1007/s11605-020-04791-4 | DOI Listing |
Front Oncol
January 2025
Electrocardiogram Room, Huai'an Third People's Hospital, Jiangsu, China.
This article reports a rare case of esophageal submucosal gland duct adenoma (ESGDA). The patient was found to have this tumor after undergoing endoscopy in an outpatient clinic due to occasional tingling while eating. White light endoscopy revealed the tumor as a dumbbell-shaped bulge, and ultrasound endoscopy revealed it as a hypoechoic mass located in the submucosal layer.
View Article and Find Full Text PDFJ Investig Med High Impact Case Rep
January 2025
Blanchard Valley Health System, OH, USA.
Oxyntic gland adenomas (OGAs) are benign gastric neoplasms composed of gland-forming epithelial cells with predominantly chief cell differentiation resembling oxyntic glands confined to the mucosa. If the tumor has submucosal invasion, it should be classified as gastric adenocarcinoma of fundic gland type. The OGAs can pose a diagnostic challenge, as they can resemble aggressive gastric neoplasms.
View Article and Find Full Text PDFObjectives: Endoscopic full-thickness resection for gastric submucosal tumors is gradually gaining popularity, and secure and amenable closure is key to its success. This study aimed to compare the reopenable clip over-the-line method with the purse-string method for defect closure after endoscopic full-thickness resection for gastric submucosal tumors.
Methods: This historical control trial included 37 consecutive patients with 37 gastric submucosal tumors, who underwent endoscopic full-thickness resection between January 2021 and July 2024.
Int J Colorectal Dis
January 2025
Department of Anatomical Pathology, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan.
Endoscopy
December 2025
Department of Gastroenterology, Tane General Hospital, Osaka, Japan.
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