Project description:Endoscopic submucosal dissection (ESD) is the standard endoscopic treatment for early esophageal cancer. Esophageal stricture often occurs at the site of ESD for large lesions. When treating a metachronous lesion appearing at the severe stricture, it may be difficult to negotiate a conventional endoscope through the stricture. Using a thin endoscope may be a useful strategy for such lesions, though ESD using a thin endoscope is challenging because of poor maneuverability. Herein, we report a case of successful ESD for early esophageal cancer at the severe stricture, using a conventional endoscope. A 72-year-old man with a previous history of ESD for esophageal cancer and a post-ESD esophageal stricture was referred to our hospital for metachronous early esophageal cancer. The lesion, 10 mm in diameter, was located at the stricture with a slight distal extension. Conventional endoscopes could not be negotiated through stricture. Therefore, submucosal dissection was performed from the oral to the anal aspect of the lesion, as far as possible. After completion of submucosal dissection of the oral aspect of the lesion and part of the lesion located on the stricture, the severe stricture was released, allowing the passage of conventional endoscope, and ESD of the entire lesion was completed en bloc. Histopathological examination showed squamous cell carcinoma, pT1a-LPM. Stricture due to scarring may occur during the regeneration process of the defective mucosa, muscularis mucosa, and submucosal layer. Therefore, incision and dissection of the contracted mucosa, mucularis mucosa, and submucosal layer would release the stenosis.

| S-EPMC8828227 | biostudies-literature

Variceal ligation in decompensated cirrhosis before esophageal endoscopic submucosal dissection.

Project description:Video 1This video details our case as well as our method for successfully eradicating varices immediately prior to esophageal endoscopic submucosal dissection to minimize risks of variceal hemorrhage.

| S-EPMC9716359 | biostudies-literature

Endoscopic closure assisted by a novel traction device after duodenal endoscopic submucosal dissection.

Project description: Not available

| S-EPMC7482248 | biostudies-literature

Efficacy of endoscopic ligation with O-ring closure for prevention of bleeding after gastric endoscopic submucosal dissection under antithrombotic therapy: a prospective observational study.

Project description:BackgroundWe examined the efficacy of a novel endoscopic ligation technique with O-ring closure (E-LOC) to prevent bleeding after gastric endoscopic submucosal dissection (ESD) under antithrombotic therapy.MethodsThis single-center prospective study involved consecutive patients who were taking antithrombotic agents and underwent gastric ESD. E-LOC was performed by anchoring the nylon loop with hemoclips on both defect edges and/or the exposed muscle layer, and using O-ring band ligation around these deployed clips. The primary outcome was post-ESD bleeding rate. Secondary outcomes were complete closure rate, procedure time, sustained closure rate, and complications.Results48 patients were finally analyzed. The post-ESD bleeding rate was 0 %, the complete closure rate was 97.9 %, and the mean closure time was 29.9 minutes. The sustained closure rate was 95.8 % at postoperative day 2-3 and 33.3 % at postoperative day 10-11. No complications occurred.ConclusionE-LOC may be an effective option for closing mucosal defects after gastric ESD under antithrombotic therapy. However, the preventive effect on post-ESD bleeding should be further investigated in high risk groups.

| S-EPMC9613440 | biostudies-literature

Comparison of endoscopic submucosal resection with ligation and endoscopic submucosal dissection for small rectal neuroendocrine tumors: A multicenter retrospective study.

Project description:ObjectivesEndoscopic submucosal resection with band ligation (ESMR-L) and endoscopic submucosal dissection (ESD) are both standard endoscopic resection methods for rectal neuroendocrine tumors (NETs) <10 mm in size. However, there is no definitive consensus on which is better. Here, we compared the efficacy of ESMR-L and ESD for small rectal NETs.MethodsThis was a multicenter retrospective cohort study including 205 patients with rectal NETs who underwent ESMR-L or ESD. Treatment outcomes were compared by univariate analysis, multivariate analysis, and inverse probability treatment weighting (IPTW) using propensity scores. Subgroup analysis evaluated the impact of the endoscopist's experience on the technical outcome.ResultsEighty-nine patients were treated by ESMR-L and 116 by ESD. The R0 resection rate was not significantly different between the two (90% vs. 92%, p = 0.73). The procedure time of ESMR-L was significantly shorter than for ESD (17 min vs. 52 min, p < 0.01) and the hospitalization period was also significantly shorter (3 days vs. 5 days, p < 0.01). These results were confirmed by multivariate analysis and also after IPTW adjustment. The procedure time of ESD was significantly prolonged by a less-experienced endoscopist (49 min vs. 70 min, p = 0.02), but that of ESMR-L was not affected (17 min vs. 17 min, p = 0.27).ConclusionsFor small rectal NETs, both ESMR-L and ESD showed similar high complete resection rates. However, considering the shorter procedure time and shorter hospitalization period, ESMR-L is the more efficient treatment method, especially for less-experienced endoscopists.

| S-EPMC9478042 | biostudies-literature

Hybrid endoscopic submucosal dissection with novel helix tacking system for defect closure.

Project description:Video 1Hybrid endoscopic submucosal dissection with novel helix tacking system for defect closure.

| S-EPMC8503940 | biostudies-literature

Underwater reopenable clip closure of mucosal defects after duodenal endoscopic submucosal dissection.

Project description: Not available

| S-EPMC7651752 | biostudies-literature