Fukuhara Motomitsu, Urabe Yuji, Nakamura Takeo, Ishibashi Kazuki, Konishi Hirona, Mizuno Junichi, Takasago Takeshi, Tanaka Hidenori, Tsuboi Akiyoshi, Yamashita Ken, Hiyama Yuichi, Takigawa Hidehiko, Kotachi Takahiro, Yuge Ryo, Ishikawa Akira, Taruya Takayuki, Ueda Tsutomu, Takeno Sachio, Oka Shiro
Department of Gastroenterology Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan.
Gastrointestinal Endoscopy and Medicine Hiroshima University Hospital Hiroshima Japan.
DEN Open. 2024 Sep 12;5(1):e70003. doi: 10.1002/deo2.70003. eCollection 2025 Apr.
Endoscopic treatment of superficial pharyngeal carcinomas includes endoscopic submucosal dissection (ESD; usually performed by endoscopists), and endoscopic laryngo-pharyngeal surgery (ELPS; primarily performed by otolaryngologists). Few studies have compared the efficacy of the two techniques in treating superficial pharyngeal carcinomas. In this study, we compared the outcomes of these two techniques to determine the advantages.
We retrospectively examined the short- and long-term outcomes of 93 consecutive patients with superficial pharyngeal carcinoma who either underwent an ESD or ELPS between August 2008 and December 2021.
There were 35 lesions among 29 patients and 93 lesions among 71 patients in the ESD and ELPS groups, respectively. The ELPS group had a significantly shorter procedure time (121.2 ± 97.4 min vs. 54.7 ± 40.2 min, p<0.01), greater procedure speed (0.10 ± 0.06 min/min vs. 0.30 ± 0.23 min/min, p<0.01), and less laryngeal edema than that of the ESD group. There were no significant differences in the 3-year overall, relapse-free, or disease-specific survival rates between the two groups. Intervention with ESD during ELPS was most commonly required when it was difficult to secure the visual field.
There were no differences in batch resection rates or long-term prognoses between the two groups; nevertheless, the ELPS group had a shorter treatment time and less laryngeal edema than the ESD group. However, the treatment of narrow areas, such as the esophageal inlet patch, is a technical limitation of ELPS; thus, ELPS should be combined with ESD techniques.
下咽浅表性癌的内镜治疗包括内镜黏膜下剥离术（ESD，通常由内镜医师进行）和内镜下咽喉手术（ELPS，主要由耳鼻喉科医师进行）。很少有研究比较这两种技术治疗下咽浅表性癌的疗效。在本研究中，我们比较了这两种技术的治疗结果以确定其优势。
我们回顾性分析了2008年8月至2021年12月期间连续93例接受ESD或ELPS治疗的下咽浅表性癌患者的短期和长期结果。
ESD组29例患者有35个病灶，ELPS组71例患者有93个病灶。ELPS组的手术时间明显更短（121.2±97.4分钟对54.7±40.2分钟，p<0.01），手术速度更快（0.10±0.06分钟/分钟对0.30±0.23分钟/分钟，p<0.01），且喉水肿比ESD组少。两组的3年总生存率、无复发生存率或疾病特异性生存率无显著差异。当难以确保视野时，ELPS手术中最常需要进行ESD干预。
两组的整块切除率和长期预后无差异；然而，ELPS组的治疗时间比ESD组短，喉水肿也更少。然而，ELPS在治疗狭窄区域，如食管入口斑块时存在技术局限性；因此，ELPS应与ESD技术联合使用。
