Esophageal ESD: technique and prevention of complications

Tsuneo Oyama

doi:10.1016/j.giec.2013.12.001

Esophageal ESD: technique and prevention of complications

Gastrointest Endosc Clin N Am. 2014 Apr;24(2):201-12. doi: 10.1016/j.giec.2013.12.001.

Author

Tsuneo Oyama¹

Affiliation

¹ Department of Gastroenterology, Saku Central Hospital, 197 Usuda, Saku, Nagano 3840301, Japan. Electronic address: oyama@coral.ocn.ne.jp.

PMID: 24679232
DOI: 10.1016/j.giec.2013.12.001

Abstract

The advantage of endoscopic submucosal dissection (ESD) is the ability to achieve high R0 resection, providing low local recurrence rate. Esophageal ESD is technically more difficult than gastric ESD due to the narrower space of the esophagus for endoscopic maneuvers. Also, the risk of perforation is higher because of the thin muscle layer of the esophageal wall. Blind dissection should be avoided to prevent perforation. A clip with line method is useful to keep a good endoscopic view with countertraction. Only an operator who has adequate skill should perform esophageal ESD.

Keywords: Endoscopic clip; Endoscopic submucosal dissection (ESD); Esophageal ESD; Perforation.

Publication types

Review

MeSH terms

Carcinoma, Squamous Cell / surgery*
Dissection / methods
Esophageal Neoplasms / surgery*
Esophageal Perforation / prevention & control*
Esophagoscopy / methods*
Esophagus / surgery*
Humans
Mucous Membrane / surgery*