CLINICAL EFFECTIVENESS OF ENDOSCOPIC SUBMUCOSAL DISSECTION IN THE MANAGEMENT OF SUPERFICIAL ESOPHAGEAL NEOPLASMS ASSOCIATED WITH BARRETT'S ESOPHAGUS.

Q2 Medicine

Arquivos de Gastroenterologia Pub Date : 2026-03-02 eCollection Date: 2026-01-01 DOI:10.1590/S0004-2803.24612025-033

Rúbia Moresi Vianna DE Oliveira, Josué Aliaga Ramos, Jonathan Richard White, Vitor Nunes Arantes

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引用次数: 0

Abstract

Background: The main clinical impact of superficial neoplasms associated with Barrett's esophagus lies in their increasing oncogenic potential in the medium and long term. For this reason, the main international guidelines agree on the importance of their early eradication. However, controversy persists as to the most appropriate endoscopic resection technique either endoscopic mucosal resection or endoscopic submucosal dissection (ESD) that guarantees the best resective quality standards.

Objective: This study aims to present the results of the clinical application of endoscopic submucosal dissection to manage superficial esophageal neoplasms in Barrett's esophagus.

Methods: A retrospective analysis was performed on a prospectively collected database on consecutive patients treated with ESD for superficial neoplasms associated with Barrett's esophagus, between 2009 and 2022. The following clinical outcomes were assessed: en-bloc, complete and curative resection rates, local recurrence, adverse events and procedure-related mortality.

Results: Esophageal ESD was carried out in 27 patients with a final histological diagnosis of adenocarcinoma in 55.6% and high-grade intraepithelial neoplasia in 44.4%. En bloc and complete resection rates were 96.2% and 85.1%, respectively. The curative resection rate was 77.7%. Adverse events occurred in two cases (7.4%). The mean post ESD endoscopic follow up was 22.1 months. Disease free survival rate at 2 years was 88.9%.

Conclusion: ESD performed by trained endoscopists is feasible, safe and clinically effective for managing early Barrett's esophagus neoplasm.

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内镜下粘膜剥离术治疗barrett食管浅表性食管肿瘤的临床疗效。

背景：与Barrett食管相关的浅表肿瘤的主要临床影响在于其中长期的致癌潜力增加。出于这个原因，主要的国际准则都同意尽早消灭这些疾病的重要性。然而，内镜下粘膜切除术和内镜下粘膜剥离术（ESD）孰优孰负，仍有争议。目的：本研究旨在介绍内镜下粘膜下剥离治疗Barrett食管浅表性食管肿瘤的临床应用结果。方法：回顾性分析前瞻性收集的2009年至2022年间连续接受ESD治疗Barrett食管浅表肿瘤患者的数据库。评估了以下临床结果：整体、完全和治愈切除率、局部复发率、不良事件和手术相关死亡率。结果：27例患者行食管ESD，最终组织学诊断为腺癌的占55.6%，高级别上皮内瘤变的占44.4%。整体切除率为96.2%，完全切除率为85.1%。治愈率为77.7%。不良事件2例（7.4%）。术后平均随访时间为22.1个月。2年无病生存率为88.9%。结论：经培训的内镜医师进行ESD治疗早期Barrett食管肿瘤是可行、安全、有效的。

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

Arquivos de Gastroenterologia Medicine-Gastroenterology

CiteScore

2.00

自引率

0.00%

发文量

109

审稿时长

9 weeks

期刊介绍： The journal Arquivos de Gastroenterologia (Archives of Gastroenterology), a quarterly journal, is the Official Publication of the Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia IBEPEGE (Brazilian Institute for Studies and Research in Gastroenterology), Colégio Brasileiro de Cirurgia Digestiva - CBCD (Brazilian College of Digestive Surgery) and of the Sociedade Brasileira de Motilidade Digestiva - SBMD (Brazilian Digestive Motility Society). It is dedicated to the publishing of scientific papers by national and foreign researchers who are in agreement with the aim of the journal as well as with its editorial policies.