Safety and Efficacy of Endoscopic Submucosal Dissection in the Management of Gastric Tube Cancers After Esophagectomy: A Systematic Review.
carcinoma esophagus
endoscopic submucosal dissection
gastric tube
gi endoscopy
systematic review and meta-analysis
Journal
Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737
Informations de publication
Date de publication:
Jun 2023
Jun 2023
Historique:
accepted:
16
06
2023
medline:
18
7
2023
pubmed:
18
7
2023
entrez:
18
7
2023
Statut:
epublish
Résumé
Esophagectomy is the proposed standard of care for resectable primary esophageal cancers and recurrent lesions in the reconstructed gastric tube (GT); however, it carries significant morbidity and mortality. Endoscopic submucosal dissection (ESD) has established its role in the management of primary esophageal cancers with growing evidence of its safety in resecting recurrent primary lesions in GT. Our study aims to evaluate the safety and efficacy of ESD in the management of recurrent, localized primary esophageal cancers in GT. We searched PubMed, CENTRAL, EMBASE, Scopus, and clinical trial registries from inception to March 2023 for articles evaluating the safety and efficacy of ESD in the management of recurrent cancerous lesions in GT. Our primary outcome was the en bloc resection rate. Secondary outcomes were curative resection rate, complete resection rate, intra-procedural complication rate, post-procedure complication rate, and five-year survival rate. Seven studies with a total of 165 patients undergoing 192 ESDs were included in the review. The pooled en bloc resection rate was 92.5% (95% CI: 87.7-95.6), which was reported in all seven studies. Pooled complete resection rate was 78.9% (95% CI: 64.5-88.5) per three studies, pooled curative resection rate was 73.9% (95% CI: 63.5-82.2) per four studies, and pooled intra-procedural complication rate was 10.2% (95% CI: 1.5-46.3), which was reported in four studies. Only three studies reported a five-year survival rate that was 65.5% (95% CI: 56.0-73.9). ESD is safe and efficacious in the management of GT cancer after esophagectomy.
Identifiants
pubmed: 37461759
doi: 10.7759/cureus.40526
pmc: PMC10350321
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
e40526Informations de copyright
Copyright © 2023, Agrawal et al.
Déclaration de conflit d'intérêts
Dr. Villa is a consultant for Medtronic, Noah Medical Corporation, and Olympus Corporation. Dr. Boulay is a consultant for Boston Scientific Corporation. All other authors disclosed no financial relationships
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