Allama Iqbal Medical College, Lahore, Punjab, Pakistan.
Hackensack University-Palisades Medical Center, North Bergen, NJ, USA.
J Investig Med High Impact Case Rep. 2020 Jan-Dec;8:2324709620941318. doi: 10.1177/2324709620941318.
With the ameliorated resectability prowess of endoscopic techniques, a myriad of diseases previously treated by major ablative surgeries are now endoscopically curable. Endoscopic submucosal tunnel dissection (ESTD) is a relatively new technique that has diversified endoscopic application. Although ESTD has frequently been used for the resection of esophageal neoplastic lesions, the clinical evidence pertaining to its efficacy in the treatment of circumferential Barrett's esophagus remains sparse. In this study, we evaluated ESTD as a potential therapeutic technique in patients with Barrett's esophagus-related high-grade dysplasia. The tunneling strategy helped achieve complete en bloc resection at an increased dissection speed, without any procedural complications. This article illustrates that ESTD can be a feasible, safe, and effective treatment for dysplastic Barrett's esophagus. Future research should aim to stratify the potential risks and complications associated with this optimization of endoscopic submucosal dissection in patients with superficial esophageal lesions.
随着内镜技术可切除性的提高,以前需要通过大型消融手术治疗的许多疾病现在都可以通过内镜治愈了。内镜黏膜下隧道剥离术(ESTD)是一种相对较新的技术,它使内镜的应用多样化。虽然 ESTD 已广泛用于切除食管的肿瘤性病变,但关于其治疗环形 Barrett 食管的疗效的临床证据仍然很少。在这项研究中,我们评估了 ESTD 作为 Barrett 食管相关高级别异型增生患者的一种潜在治疗技术。隧道策略有助于以增加的剥离速度实现完全整块切除,没有任何程序并发症。本文表明,ESTD 可以作为治疗异型增生性 Barrett 食管的一种可行、安全和有效的方法。未来的研究应该旨在分层与浅表性食管病变患者内镜黏膜下剥离术的这种优化相关的潜在风险和并发症。