Circumferential endoscopic submucosal dissection of a 14-cm long-segment Barrett’s esophagus with multifocal adenocarcinoma: a case report

Q3 Medicine

VideoGIE Pub Date : 2025-05-27 DOI:10.1016/j.vgie.2025.05.001

Aida Saad MD , Joyce Arnouk MD , Arshia Khorasani-Zadeh MD , Monika Seth MD , Kais Zakharia MD

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引用次数: 0

Abstract

Background and Aims

Barrett's esophagus (BE) is a recognized precursor to esophageal adenocarcinoma (EAC), with an annual progression risk of up to 7% in cases involving high-grade dysplasia (HGD). Endoscopic therapy is the standard treatment for dysplastic BE and early-stage EAC, typically involving ablation techniques, such as radiofrequency ablation and cryotherapy, for flat BE and endoscopic resection methods, including EMR and more recently endoscopic submucosal dissection (ESD), for nodular lesions.

Methods

This article describes the case of a patient with an ultralong segment of BE (14 cm) and multifocal EAC who was successfully treated with circumferential ESD.

Results

A complete en bloc resection of a 16-cm segment was achieved. Histopathologic analysis confirmed the presence of BE with HGD and multifocal EAC (T1b). Although the patient developed an esophageal stricture postprocedure, it was effectively managed endoscopically.

Conclusions

The patient is currently doing well and remains under routine endoscopic and radiographic surveillance. Circumferential ESD represents a safe and effective approach for the endoscopic resection of extensive BE and early EAC and should be considered a viable alternative to surgical intervention.

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14cm长段Barrett食管合并多灶性腺癌的环周内镜粘膜下剥离1例

背景和AimsBarrett食管（BE）是公认的食管腺癌（EAC）的前兆，在涉及高级别发育不良（HGD）的病例中，其年进展风险高达7%。内镜治疗是发育不良BE和早期EAC的标准治疗方法，通常包括消融技术，如射频消融和冷冻治疗，用于扁平BE和内镜切除方法，包括EMR和最近的内镜粘膜下剥离（ESD），用于结节性病变。方法本文报道1例超长段BE （14 cm）伴多灶性EAC的患者，采用环向ESD成功治疗。结果实现了16 cm节段的完整切除。组织病理学分析证实BE合并HGD和多灶性EAC （T1b）。虽然患者术后出现食管狭窄，但经内镜有效处理。结论该患者目前情况良好，仍在常规内镜和影像学监测下。环向ESD是一种安全有效的内镜切除广泛BE和早期EAC的方法，应被视为手术干预的可行选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

VideoGIE Medicine-Gastroenterology

CiteScore

1.50

自引率

0.00%

发文量

132

审稿时长

105 days

期刊介绍： VideoGIE, an official video journal of the American Society for Gastrointestinal Endoscopy, is an Open Access, online-only journal to serve patients with digestive diseases. VideoGIE publishes original, single-blinded peer-reviewed video case reports and case series of endoscopic procedures used in the study, diagnosis, and treatment of digestive diseases. Videos demonstrate use of endoscopic systems, devices, and techniques; report outcomes of endoscopic interventions; and educate physicians and patients about gastrointestinal endoscopy. VideoGIE serves the educational needs of endoscopists in training as well as advanced endoscopists, endoscopy staff and industry, and patients. VideoGIE brings video commentaries from experts, legends, committees, and leadership of the society. Careful adherence to submission guidelines will avoid unnecessary delays, as incomplete submissions may be returned to the authors before initiation of the peer review process.