Endoscopic submucosal dissection for early cancers or precancerous lesions of the upper GI tract in cirrhotic patients with esophagogastric varices: 10-year experience from a large tertiary center in China - 17/05/23
, Lian-Yong Li, MD 2, ⁎ Abstract |
Background and Aims |
Treatment strategies for early cancers or precancerous lesions of the upper GI tract in patients with cirrhosis and esophagogastric varices (EGVs) are complicated and risky. The aim of this study was to assess the efficacy and safety of endoscopic submucosal dissection (ESD) in the treatment of such patients and explore optimal treatment strategies.
Methods |
We retrospectively enrolled 15 patients with cirrhosis and EGV who underwent ESD for early cancers or precancerous lesions of the upper GI tract from January 2012 to December 2021 at our center. Clinical features, endoscopic findings, treatment methods, adverse events, and follow-up data were analyzed.
Results |
Of the 15 patients, 1 had a platelet count < 30 × 1000/mm 3 . Five were untreated for EGV, 1 was treated after ESD, 6 were treated before ESD, 1 was treated before and during ESD, and 2 were treated during ESD. The R0 resection rate was 100%. Of the 16 mucosal lesions, 15 were endoscopic resection bleeding (ERB)-0 or ERB-c1, and 1 was ERB-c2. No patient experienced deterioration in liver function. The only adverse events were fever in 2 patients and postoperative bleeding in 2 patients. During a median follow-up of 27 months, 1 patient’s esophageal high-grade dysplasia recurred at 19 months. No death resulted from the ESD procedure, liver function injury, or GI tumor itself.
Conclusions |
ESD is an effective and safe treatment for early cancers or precancerous lesions of the upper GI tract in patients with cirrhosis and EGV. The incidence of severe adverse events is very low due to the development of individualized clinical treatment strategies.
Il testo completo di questo articolo è disponibile in PDF.Abbreviations : APC, EGV, EIS, ERB, ESD, EV, EVL, GV, HGD, ME + NBI, PB
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| DISCLOSURE: All authors disclosed no financial relationships. |
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| DIVERSITY, EQUITY, AND INCLUSION: We worked to ensure the following: gender balance in the recruitment of human subjects, ethnic or other types of diversity in the recruitment of human subjects, and that the language of the study questionnaires reflected inclusion. While citing references scientifically relevant for this work, we actively worked to promote gender balance in our reference list. The author list of this paper includes contributors from the location where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work. |
Vol 97 - N° 6
P. 1031-1044 - giugno 2023 Ritorno al numero
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