医学
食管静脉曲张
四分位间距
食管
静脉曲张
穿孔
食道疾病
食管狭窄
内窥镜检查
外科
回顾性队列研究
放射科
胃肠病学
内科学
肝硬化
门脉高压
冲孔
材料科学
冶金
作者
Shruti Mony,Bing Hu,Abel Joseph,Hiroyuki Aihara,Lorenzo Ferri,Amit Bhatt,Amit Mehta,Brian Ting,Alex Chen,Andrew Kalra,Jad Farha,Manabu Onimaru,Andrew Wang,Libang He,Qi Luo,Haruhiro Inoue,Saowanee Ngamruengphong
出处
期刊:Endoscopy
[Georg Thieme Verlag KG]
日期:2023-08-23
卷期号:56 (02): 119-124
摘要
Background There are limited data on the feasibility of endoscopic submucosal dissection (ESD) for superficial esophageal neoplasia (SEN) located at or adjacent to esophageal varices. We aimed to evaluate the outcomes of ESD in these patients. Methods This multicenter retrospective study included cirrhotic patients with a history of esophageal varices with SEN located at or adjacent to the esophageal varices who underwent ESD. Results 23 patients with SEN (median lesion size 30 mm; 16 squamous cell neoplasia and seven Barrett’s esophagus-related neoplasia) were included. The majority were Child–Pugh B (57 %) and had small esophageal varices (87 %). En bloc, R0, and curative resections were achieved in 22 (96 %), 21 (91 %), and 19 (83 %) of patients, respectively. Severe intraprocedural bleeding (n = 1) and delayed bleeding (n = 1) were successfully treated endoscopically. No delayed perforation, hepatic decompensation, or deaths were observed. During a median (interquartile range) follow-up of 36 (22–55) months, one case of local recurrence occurred after noncurative resection. Conclusion ESD is feasible and effective for SEN located at or adjacent to esophageal varices in cirrhotic patients. Albeit, the majority of the esophageal varices in our study were small in size, when expertise is available, ESD should be considered as a viable option for such patients.
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