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Chinese Journal of Clinicians(Electronic Edition) ›› 2019, Vol. 13 ›› Issue (09): 675-679. doi: 10.3877/cma.j.issn.1674-0785.2019.09.007

Special Issue:

• Clinical Research • Previous Articles     Next Articles

Endoscopic submucosal dissection for treatment of patients with esophageal intramucosal and submucosal cancer: efficacy and factors influencing operative time

Yuxin Wang1, Jijun Zhu1, Yunyun Liu1, Yan Wang1, Wei Liu1, Fengjuan Cai1, Xiaoyan Wang1,()   

  1. 1. Department of Gastroenterology, Suqian No. 1 People′s Hospital, Suqian 223800, China
  • Received:2019-03-18 Online:2019-05-01 Published:2019-05-01
  • Contact: Xiaoyan Wang
  • About author:
    Corresponding author: Wang Xiaoyan, Email:

Abstract:

Objective

To evaluate the efficacy of endoscopic submucosal tunnel dissection (ESTD) in the treatment of esophageal intramucosal and submucosal cancer and explore the factors influencing operation time.

Methods

A total of 133 patients with esophageal intramucosal and submucosal carcinomas treated at our hospital from November 2015 to December 2018 were retrospectively analyzed. Among them, 80 patients were treated by endoscopic submucosal dissection (ESD; group A) and 53 patients were treated by ESTD (group B). Logistic regression analysis was used to identify the factors influencing operation time.

Results

There was no significant difference between the two groups in the rates of total excision and radical excision (P>0.05); the total operation time and the time of submucosal dissection in group B were significantly less than those of group A (P<0.05). The speed of submucosal dissection in group B was significantly higher than that in group A (P<0.05). There was no significant difference in the rates of bleeding, fever, and chest pain after operation between the two groups (P>0.05). The rates of muscle layer injury and bleeding during operation in group B were significantly lower than those of group A (P<0.05). Logistic regression analysis showed that ESTD application and lesion area<9 cm2 were independent influencing factors of operation time (P<0.05).

Conclusion

ESTD for esophageal intramucosal and submucosal carcinomas can effectively shorten total operation time and submucosal dissection time, improve the speed of mucosal dissection, and reduce the incidence of intraoperative myometrial injury and intraoperative bleeding, with a similar overall resection effect to ESD. Operation time is closely related to the type of endoscopy and the area of lesion.

Key words: Endoscopic submucosal tunnel dissection, Esophageal neoplasms, Intramucosal cancer, Submucosal cancer, Operation time

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