Efficacy of Endoscopic Submucosal Dissection for Superficial Esophageal Cancer on the Distal Side of Esophageal Strictures Using a Novel Thin Therapeutic Endoscope

Abstract

Objectives

Endoscopic submucosal dissection (ESD) for esophageal squamous cell carcinomas (ESCCs) localized on the distal side of strictures requires dilation to pass a conventional endoscope. While an ultra-slim endoscope can pass without dilation, ESD using it remains clinically challenging. Despite its small outer diameter of only 7.9 mm, the EG-840TP features a 3.2-mm working channel, an auxiliary water channel, and 160° downward angulation capability. We evaluated the efficacy and safety of ESD using the EG-840TP for ESCCs localized on the distal side of strictures.

Methods

This retrospective study included patients who underwent ESD for ESCCs localized on the distal side of strictures that a conventional endoscope (diameter ≥8.9 mm) could not pass at our institute from December 2015 to November 2024. Patients were categorized into novel thin endoscope (the EG-840TP) and conventional endoscope (treated after stricture dilation) groups. Patients with strictures narrower than 6 mm were excluded.

Results

Of 28 patients (36 lesions), 13 patients (19 lesions) underwent ESD using the novel thin endoscope, whereas 15 patients (17 lesions) underwent ESD using the conventional endoscope. The treatment speed was significantly faster in the novel thin endoscope group (4.91 mm²/min vs. 1.63 mm²/min, p = 0.03). No serious adverse events were observed in either group.

Conclusions

ESD using the EG-840TP demonstrated superior efficacy for superficial ESCCs located on the distal side of strictures, offering an alternative to dilation-based approaches.