Ramos Josué Aliaga, Morita Yoshinori, Toyonaga Takashi, Carvalho Danilo, Pedrosa Moises Salgado, Arantes Vitor N
Department of Gastroenterology, "Jose Agurto Tello-Chosica" Hospital, Lima, Perú.
Digestive Endoscopy Unit of San Pablo Clinic, Lima, Perú.
Clin Endosc. 2023 Sep;56(5):613-622. doi: 10.5946/ce.2022.245. Epub 2023 May 17.
BACKGROUND/AIMS: Endoscopic submucosal dissection (ESD) is currently considered the first-line treatment for the eradication of superficial neoplasms of the esophagus in Eastern countries. However, in the West, particularly in Latin America, the experience with esophageal ESD is still limited because of the high technical complexity required for its execution. This study aimed to present the results of the clinical application of ESD to manage superficial esophageal neoplasms in a Latin American center in over 100 consecutive cases.
This retrospective study included consecutive patients who underwent endoscopic ESD for superficial esophageal neoplasms between 2009 and 2022. The following clinical outcomes were assessed: en bloc, complete, and curative resection rates, local recurrence, adverse events, and procedure-related mortality.
Esophageal ESD was performed mainly for squamous cell carcinoma (66.6%), high-grade intraepithelial neoplasia (17.1%), and adenocarcinoma (11.4%). En bloc and complete resection rates were 96.2% and 81.0%, respectively. The curative resection rate was 64.8%. Adverse events occurred in six cases (5.7%). Endoscopic follow-up was performed for an average period of 29.7 months.
ESD performed by trained operators is feasible, safe, and clinically effective for managing superficial neoplastic lesions of the esophagus in Latin America.
背景/目的：在东方国家，内镜黏膜下剥离术（ESD）目前被认为是根除食管浅表肿瘤的一线治疗方法。然而，在西方，尤其是在拉丁美洲，由于实施食管ESD所需的技术复杂性高，其经验仍然有限。本研究旨在介绍在拉丁美洲一家中心对100多例连续病例应用ESD治疗食管浅表肿瘤的临床结果。
这项回顾性研究纳入了2009年至2022年间因食管浅表肿瘤接受内镜ESD治疗的连续患者。评估了以下临床结果：整块切除率、完整切除率、根治性切除率、局部复发、不良事件和手术相关死亡率。
食管ESD主要用于治疗鳞状细胞癌（66.6%）、高级别上皮内瘤变（17.1%）和腺癌（11.4%）。整块切除率和完整切除率分别为96.2%和81.0%。根治性切除率为64.8%。6例（5.7%）发生不良事件。平均进行了29.7个月的内镜随访。
由训练有素的操作人员进行的ESD对于管理拉丁美洲食管浅表肿瘤性病变是可行、安全且临床有效的。
