Outcomes of endoscopic submucosal dissection for esophageal cancer with segmental absence of intestinal musculature.
Journal
Gastrointestinal endoscopy
ISSN: 1097-6779
Titre abrégé: Gastrointest Endosc
Pays: United States
ID NLM: 0010505
Informations de publication
Date de publication:
Apr 2024
Apr 2024
Historique:
received:
16
11
2023
revised:
17
10
2023
accepted:
19
01
2024
pubmed:
13
11
2023
medline:
13
11
2023
entrez:
12
11
2023
Statut:
ppublish
Résumé
Perforation during esophageal endoscopic submucosal dissection (ESD) typically results from electrical damage. However, there are cases in which perforation occurs because of segmental absence of intestinal musculature (SAIM) without iatrogenic muscular injury. We investigated the occurrence rate and clinical course of SAIM during esophageal ESD. We conducted a retrospective review of esophageal ESDs performed between 2013 and 2019 at 10 centers in Japan. Five of 1708 (0.29%) patients received ESD for esophageal cancer and had SAIM. The median muscular defect size was 20 mm. All lesions were resected without discontinuation. After resection, 3 patients were closed with Endoloop. Four patients had mediastinal emphysema. All patients were managed conservatively. SAIM is a very rare condition that is usually only diagnosed during ESD. Physicians performing esophageal ESD should be aware of SAIM. When SAIM is detected, the ESD technique should be modified to prevent full-thickness perforation.
Sections du résumé
BACKGROUND AND AIMS
OBJECTIVE
Perforation during esophageal endoscopic submucosal dissection (ESD) typically results from electrical damage. However, there are cases in which perforation occurs because of segmental absence of intestinal musculature (SAIM) without iatrogenic muscular injury. We investigated the occurrence rate and clinical course of SAIM during esophageal ESD.
METHODS
METHODS
We conducted a retrospective review of esophageal ESDs performed between 2013 and 2019 at 10 centers in Japan.
RESULTS
RESULTS
Five of 1708 (0.29%) patients received ESD for esophageal cancer and had SAIM. The median muscular defect size was 20 mm. All lesions were resected without discontinuation. After resection, 3 patients were closed with Endoloop. Four patients had mediastinal emphysema. All patients were managed conservatively.
CONCLUSIONS
CONCLUSIONS
SAIM is a very rare condition that is usually only diagnosed during ESD. Physicians performing esophageal ESD should be aware of SAIM. When SAIM is detected, the ESD technique should be modified to prevent full-thickness perforation.
Identifiants
pubmed: 37952682
pii: S0016-5107(23)03043-2
doi: 10.1016/j.gie.2023.11.007
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
629-632Informations de copyright
Copyright © 2024 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Disclosure The following authors disclosed financial relationships: Y. Yamamoto: Speaker or teacher for Maiji Seika Pharma and Taiho Pharmaceutical. T. Sako: Speaker or teacher for Daiichi Sankyo. T. Ishida: Speaker or teacher for Fujifilm, Mitsubishi Tanabe Pharma, Michida Pharmaceutical, Otsuka Pharmaceutical, and Takeda Pharmaceutical. A. Ikeda: Speaker or teacher for Boston Scientific. M. Iwatate: Speaker or teacher for Olympus Medical Systems and research or other grant recipient from Asian Endoscopy Research Forum. F. Kawara: Speaker or teacher for Otsuka Pharmaceutical and Takeda Pharmaceutical. S. Tanaka: Research or other grant recipient from Health Science Foundation Research. Y. Morita: Speaker or teacher for Olympus Medical Systems and research or other grant recipient from Seed, Toyobo, and Sysmex. T. Toyonaga: Ownership interests in Olympus Medical Systems and Fujifilm and research or other grant recipient from Takeda Pharmaceutical and Daiichi Sankyo. Y. Kodama: Research or other grant recipient from Asahara Clinic, Kan Research Institute/Eisai, Otsuka Pharmaceutical, AbbVie, Takeda Pharmaceutical, Gadelius Medical, Bristol Myers Squibb, Toray, and Fujifilm. All other authors disclosed no financial relationships.