TY - JOUR
T1 - Esophageal endoscopic submucosal dissection (ESD) aiming for the safest procedure
AU - Fujishiro, Mitsuhiro
AU - Kodashima, Shinya
AU - Goto, Osamu
AU - Ono, Satoshi
AU - Niimi, Keiko
AU - Yamamichi, Nobutake
AU - Muraki, Yosuke
AU - Oka, Masashi
AU - Ichinose, Masao
AU - Omata, Masao
PY - 2008/10/1
Y1 - 2008/10/1
N2 - Endoscopic submucosal dissection (ESD) developing in the stomach has also been recognized as one of the standard treatments for esophageal neoplasms in Japan. Advantage of ESD is to be controllable in size and shape, and to be resectable even in large and fibrotic neoplasms. The disadvantage is longer procedure time, heavier bleeding, and higher possibility of perforation. Accompanying complications, especially perforation, in the esophageal ESD may result in more life-threatening outcomes than those in the stomach ESD, so the safest way to accomplish successful en bloc resection without complication should be identified. All of the following key points should be at least adequately managed to reach the goal ; 1. preoperative evaluation of the patients, 2. preoperative evaluation of the lesions, 3. preparation of endoscopic equipment and devices, 4. perioperative monitoring and sedation, 5. technical strategy for resection, 6. how to cope with complication, 7. postoperative management. In this technical note, we would like to show how to manage the above points in our departments, aiming for the safest esophageal ESD without any complication.
AB - Endoscopic submucosal dissection (ESD) developing in the stomach has also been recognized as one of the standard treatments for esophageal neoplasms in Japan. Advantage of ESD is to be controllable in size and shape, and to be resectable even in large and fibrotic neoplasms. The disadvantage is longer procedure time, heavier bleeding, and higher possibility of perforation. Accompanying complications, especially perforation, in the esophageal ESD may result in more life-threatening outcomes than those in the stomach ESD, so the safest way to accomplish successful en bloc resection without complication should be identified. All of the following key points should be at least adequately managed to reach the goal ; 1. preoperative evaluation of the patients, 2. preoperative evaluation of the lesions, 3. preparation of endoscopic equipment and devices, 4. perioperative monitoring and sedation, 5. technical strategy for resection, 6. how to cope with complication, 7. postoperative management. In this technical note, we would like to show how to manage the above points in our departments, aiming for the safest esophageal ESD without any complication.
KW - Complication
KW - Endoscopic resection
KW - Endoscopic submucosal dissection (ESD)
KW - Neoplasm
KW - Perforation
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M3 - Article
AN - SCOPUS:56549120796
VL - 50
SP - 2722
EP - 2729
JO - Gastroenterological Endoscopy
JF - Gastroenterological Endoscopy
SN - 0387-1207
IS - 10
ER -