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Endoscopic Treatment: EMR and ESD

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Abstract

Esophageal superficial cancers with negligible risk for lymph node metastasis can be cured by endoscopic local resection. Endoscopic mucosal resection (EMR) is a conventional technique, which can resect relatively small lesions by using a snare. On the contrary, endoscopic submucosal dissection (ESD) can resect superficial lesion in an en bloc fashion irrespective of size or presence of submucosal fibrosis, which has made the indication of endoscopic resection expanded. Although skillful hands of endoscopy and sufficient knowledge for management of complications such as perforation and stricture formation are required, ESD is a promising technique as a minimally-invasive treatment.

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References

  1. Ishihara R, Iishi H, Takeuchi Y, et al. Local recurrence of large squamous-cell carcinoma of the esophagus after endoscopic resection. Gastrointest Endosc. 2008a;67:799–804.

    Article  PubMed  Google Scholar 

  2. Ishihara R, Iishi H, Uedo N, et al. Comparison of EMR and endoscopic submucosal dissection for en bloc resection of early esophageal cancers in Japan. Gastrointest Endosc. 2008b;68:1066–72.

    Article  PubMed  Google Scholar 

  3. Takahashi H, Arimura Y, Masao H, et al. Endoscopic submucosal dissection is superior to conventional endoscopic resection as a curative treatment for early squamous cell carcinoma of the esophagus (with video). Gastrointest Endosc. 2010;72:255–64.

    Article  PubMed  Google Scholar 

  4. Teoh AY, Chiu PW, Yu Ngo DK, et al. Outcomes of endoscopic submucosal dissection versus endoscopic mucosal resection in management of superficial squamous esophageal neoplasms outside Japan. J Clin Gastroenterol. 2010;44:e190–4.

    Article  PubMed  Google Scholar 

  5. Japan Esophageal Society. Japanese classification of esophageal cancer, 11th edition. Esophagus. 2017;14:37–65.

    Article  Google Scholar 

  6. Eguchi T, Nakanishi Y, Shimoda T, et al. Histopathological criteria for additional treatment after endoscopic mucosal resection for esophageal cancer: analysis of 464 surgically resected cases. Mod Pathol. 2006;19:475–80.

    Article  PubMed  Google Scholar 

  7. Griffin SM, Burt AD, Jennings NA. Lymph node metastasis in early esophageal adenocarcinoma. Ann Surg. 2011;254:731–6.

    Article  CAS  PubMed  Google Scholar 

  8. Katada C, Muto M, Momma K, et al. Clinical outcome after endoscopic mucosal resection for esophageal squamous cell carcinoma invading the muscularis mucosae–a multicenter retrospective cohort study. Endoscopy. 2007;39:779–83.

    Article  CAS  PubMed  Google Scholar 

  9. Shimada H, Nabeya Y, Matsubara H, et al. Prediction of lymph node status in patients with superficial esophageal carcinoma: analysis of 160 surgically resected cancers. Am J Surg. 2006;191:250–4.

    Article  PubMed  Google Scholar 

  10. Katada C, Muto M, Manabe T, et al. Esophageal stenosis after endoscopic mucosal resection of superficial esophageal lesions. Gastrointest Endosc. 2003;57:165–9.

    Article  PubMed  Google Scholar 

  11. Mizuta H, Nishimori I, Kuratani Y, et al. Predictive factors for esophageal stenosis after endoscopic submucosal dissection for superficial esophageal cancer. Dis Esophagus. 2009;22:626–31.

    Article  CAS  PubMed  Google Scholar 

  12. Ezoe Y, Muto M, Horimatsu T, et al. Efficacy of preventive endoscopic balloon dilation for esophageal stricture after endoscopic resection. J Clin Gastroenterol. 2011;45:222–7.

    Article  PubMed  Google Scholar 

  13. Takahashi H, Arimura Y, Okahara S, et al. Risk of perforation during dilation for esophageal strictures after endoscopic resection in patients with early squamous cell carcinoma. Endoscopy. 2011;43:184–9.

    Article  CAS  PubMed  Google Scholar 

  14. Suzuki H. Endoscopic mucosal resection using ligating device for early gastric cancer. Gastrointest Endosc Clin N Am. 2001;11:511–8.

    Article  CAS  PubMed  Google Scholar 

  15. Pouw RE, van Vilsteren FG, Peters FP, et al. Randomized trial on endoscopic resection-cap versus multiband mucosectomy for piecemeal endoscopic resection of early Barrett's neoplasia. Gastrointest Endosc. 2011;74:35–43.

    Article  PubMed  Google Scholar 

  16. Inoue H, Endo M, Takeshita K, et al. A new simplified technique of endoscopic esophageal mucosal resection using a cap-fitted panendoscope (EMRC). Surg Endosc. 1992;6:264–5.

    Article  CAS  PubMed  Google Scholar 

  17. Makuuchi H. Endoscopic mucosal resection for early esophageal cancer – indication and techniques. Dig Endosc. 1996;8:175–9.

    Article  Google Scholar 

  18. Shimizu Y, Takahashi M, Yoshida T, et al. Endoscopic resection (endoscopic mucosal resection/endoscopic submucosal dissection) for superficial esophageal squamous cell carcinoma: current status of various techniques. Dig Endosc. 2013;25(Suppl. 1):13–9.

    Article  PubMed  Google Scholar 

  19. Urabe Y, Hiyama T, Tanaka S, et al. Advantages of endoscopic submucosal dissection versus endoscopic oblique aspiration mucosectomy for superficial esophageal tumors. J Gastroenterol Hepatol. 2011;26:275–80.

    Article  PubMed  Google Scholar 

  20. Yamashita T, Zeniya A, Ishii H, et al. Endoscopic mucosal resection using a cap-fitted panendoscope and endoscopic submucosal dissection as optimal endoscopic procedures for superficial esophageal carcinoma. Surg Endosc. 2011;25:2541–6.

    Article  PubMed  Google Scholar 

  21. Fukami N, Ryu CB, Said S, et al. Prospective, randomized study of conventional versus hybrid knife endoscopic submucosal dissection methods for the esophagus: an animal study. Gastrointest Endosc. 2011;73:1246–53.

    Article  PubMed  Google Scholar 

  22. Ishii N, Horiki N, Itoh T, et al. Endoscopic submucosal dissection with a combination of small-caliber-tip transparent hood and flex knife is a safe and effective treatment for superficial esophageal neoplasias. Surg Endosc. 2010;24:335–42.

    Article  PubMed  Google Scholar 

  23. Yahagi N, Uraoka T, Ida Y, et al. Endoscopic submucosal dissection using the flex and the dual knives. Tech Gastrointest Endosc. 2011;13:74–8.

    Article  Google Scholar 

  24. Akahoshi K, Minoda Y, Komori K, et al. Endoscopic submucosal dissection using the "clutch cutter" for early esophageal squamous cell carcinoma. Endoscopy. 2013;45:1035–8.

    Article  PubMed  Google Scholar 

  25. Kitagawa Y, Suzuki T, Hara T, et al. Safety and efficacy of endoscopic submucosal dissection using IT knife nano with clip traction method for early esophageal squamous cell carcinoma. Surg Endosc. 2018;32:450–5.

    Article  PubMed  Google Scholar 

  26. Kuwai T, Yamaguchi T, Imagawa H, et al. Endoscopic submucosal dissection for early esophageal neoplasms using the stag beetle knife. World J Gastroenterol. 2018;24:1632–40.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Higuchi K, Tanabe S, Azuma M, et al. A phase II study of endoscopic submucosal dissection for superficial esophageal neoplasms (KDOG 0901). Gastrointest Endosc. 2013;78:704–10.

    Article  PubMed  Google Scholar 

  28. Ono S, Fujishiro M, Niimi K, et al. Long-term outcomes of endoscopic submucosal dissection for superficial esophageal squamous cell neoplasms. Gastrointest Endosc. 2009;70:860–6.

    Article  PubMed  Google Scholar 

  29. Repici A, Hassan C, Carlino A, et al. Endoscopic submucosal dissection in patients with early esophageal squamous cell carcinoma: results from a prospective Western series. Gastrointest Endosc. 2010;71:715–21.

    Article  PubMed  Google Scholar 

  30. Yamashina T, Ishihara R, Uedo N, et al. Safety and curative ability of endoscopic submucosal dissection for superficial esophageal cancers at least 50 mm in diameter. Dig Endosc. 2012;24:220–5.

    Article  PubMed  Google Scholar 

  31. Maeda Y, Hirasawa D, Fujita N, et al. Mediastinal emphysema after esophageal endoscopic submucosal dissection: its prevalence and clinical significance. Dig Endosc. 2011;23:221–6.

    Article  PubMed  Google Scholar 

  32. Maeda Y, Hirasawa D, Fujita N, et al. A pilot study to assess mediastinal emphysema after esophageal endoscopic submucosal dissection with carbon dioxide insufflation. Endoscopy. 2012;44:565–71.

    Article  CAS  PubMed  Google Scholar 

  33. Hanaoka N, Ishihara R, Takeuchi Y, et al. Intralesional steroid injection to prevent stricture after endoscopic submucosal dissection for esophageal cancer: a controlled prospective study. Endoscopy. 2012;44:1007–11.

    Article  CAS  PubMed  Google Scholar 

  34. Hashimoto S, Kobayashi M, Takeuchi M, et al. The efficacy of endoscopic triamcinolone injection for the prevention of esophageal stricture after endoscopic submucosal dissection. Gastrointest Endosc. 2011;74:1389–93.

    Article  PubMed  Google Scholar 

  35. Mizutani T, Tadauchi A, Arinobe M, et al. Novel strategy for prevention of esophageal stricture after endoscopic surgery. Hepato-Gastroenterology. 2010;57:1150–6.

    PubMed  Google Scholar 

  36. Nonaka K, Miyazawa M, Ban S, et al. Different healing process of esophageal large mucosal defects by endoscopic mucosal dissection between with and without steroid injection in an animal model. BMC Gastroenterol. 2013;13:72.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Saito Y, Tanaka T, Andoh A, et al. Usefulness of biodegradable stents constructed of poly-l-lactic acid monofilaments in patients with benign esophageal stenosis. World J Gastroenterol. 2007;13:3977–80.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Sato H, Inoue H, Kobayashi Y, et al. Control of severe strictures after circumferential endoscopic submucosal dissection for esophageal carcinoma: oral steroid therapy with balloon dilation or balloon dilation alone. Gastrointest Endosc. 2013;78:250–7.

    Article  PubMed  Google Scholar 

  39. Takagi R, Murakami D, Kondo M, et al. Fabrication of human oral mucosal epithelial cell sheets for treatment of esophageal ulceration by endoscopic submucosal dissection. Gastrointest Endosc. 2010;72:1253–9.

    Article  PubMed  Google Scholar 

  40. Yamashita S, Kato M, Fujimoto A, et al. Inadequate steroid injection after esophageal ESD might cause mural necrosis. Endosc Int Open. 2019;7:E115–21.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Honda M, Hori Y, Nakada A, et al. Use of adipose tissue-derived stromal cells for prevention of esophageal stricture after circumferential EMR in a canine model. Gastrointest Endosc. 2011;73:777–84.

    Article  PubMed  Google Scholar 

  42. Ohki T, Yamato M, Murakami D, et al. Treatment of oesophageal ulcerations using endoscopic transplantation of tissue-engineered autologous oral mucosal epithelial cell sheets in a canine model. Gut. 2006;55:1704–10.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Ohki T, Yamato M, Ota M, et al. Prevention of esophageal stricture after endoscopic submucosal dissection using tissue-engineered cell sheets. Gastroenterology. 2012;143:582–8.

    Article  PubMed  Google Scholar 

  44. Sato H, Sagara S, Nakajima N, Akimoto T, Suzuki K, Yoneyama H, Terai S, Yahagi N. Prevention of esophageal stricture after endoscopic submucosal dissection using RNA-based silencing of carbohydrate sulfotransferase 15 in a porcine model. Endoscopy. 2017 May;49(5):491–7.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine, Tokyo, Japan

    Naohisa Yahagi & Motohiko Kato

Authors
  1. Naohisa Yahagi
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  2. Motohiko Kato
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Correspondence to Naohisa Yahagi .

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Editors and Affiliations

  1. International Goodwill Hospital, Yokohama, Japan

    Nobutoshi Ando

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Yahagi, N., Kato, M. (2020). Endoscopic Treatment: EMR and ESD. In: Ando, N. (eds) Esophageal Squamous Cell Carcinoma. Springer, Singapore. https://doi.org/10.1007/978-981-15-4190-2_9

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  • DOI: https://doi.org/10.1007/978-981-15-4190-2_9

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-15-4189-6

  • Online ISBN: 978-981-15-4190-2

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