Outcomes of endoscopic submucosal dissection for esophageal cancer with segmental absence of intestinal musculature - 18/03/24
, Yoshinobu Yamamoto, MD, PhD 2, Tomoya Sako, MD, PhD 3, Yasuaki Kitamura, MD, PhD 4, Takayuki Ose, MD, PhD 5, Tsukasa Ishida, MD, PhD 6, Atsushi Ikeda, MD 7, Ryusuke Ariyoshi, MD, PhD 8, Mineo Iwatate, MD, PhD 9, Fumiaki Kawara, MD, PhD 10, Shinwa Tanaka, MD, PhD 1, 11, Toshitatsu Takao, MD, PhD 1, Yoshinori Morita, MD, PhD 1, Takashi Toyonaga, MD, PhD 12, Yuzo Kodama, MD, PhD 1Abstract |
Background and Aims |
Perforation during esophageal endoscopic submucosal dissection (ESD) typically results from electrical damage. However, there are cases in which perforation occurs because of segmental absence of intestinal musculature (SAIM) without iatrogenic muscular injury. We investigated the occurrence rate and clinical course of SAIM during esophageal ESD.
Methods |
We conducted a retrospective review of esophageal ESDs performed between 2013 and 2019 at 10 centers in Japan.
Results |
Five of 1708 (0.29%) patients received ESD for esophageal cancer and had SAIM. The median muscular defect size was 20 mm. All lesions were resected without discontinuation. After resection, 3 patients were closed with Endoloop. Four patients had mediastinal emphysema. All patients were managed conservatively.
Conclusions |
SAIM is a very rare condition that is usually only diagnosed during ESD. Physicians performing esophageal ESD should be aware of SAIM. When SAIM is detected, the ESD technique should be modified to prevent full-thickness perforation.
Le texte complet de cet article est disponible en PDF.Abbreviations : ESD, SAIM
Plan
Vol 99 - N° 4
P. 629-632 - avril 2024 Retour au numéro
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