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CC BY-NC-ND 4.0 · Endosc Int Open 2024; 12(09): E1029-E1034
DOI: 10.1055/a-2386-9660
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Usefulness of an ultrathin endoscope in esophageal endoscopic submucosal dissection

Daisuke Kikuchi
1   Gastroenterology, Toranomon Hospital, minato-ku, Japan
,
Yugo Suzuki
1   Gastroenterology, Toranomon Hospital, minato-ku, Japan
,
Yusuke Kawai
1   Gastroenterology, Toranomon Hospital, minato-ku, Japan
,
Kosuke Nomura
1   Gastroenterology, Toranomon Hospital, minato-ku, Japan
,
Yorinari Ochiai
1   Gastroenterology, Toranomon Hospital, minato-ku, Japan
,
Junnosuke Hayasaka
1   Gastroenterology, Toranomon Hospital, minato-ku, Japan
,
Yutaka Mitsunaga
1   Gastroenterology, Toranomon Hospital, minato-ku, Japan
,
Takayuki Okamura
1   Gastroenterology, Toranomon Hospital, minato-ku, Japan
,
Hiroyuki Odagiri
1   Gastroenterology, Toranomon Hospital, minato-ku, Japan
,
Satoshi Yamashita
1   Gastroenterology, Toranomon Hospital, minato-ku, Japan
,
Akira Matsui
1   Gastroenterology, Toranomon Hospital, minato-ku, Japan
,
Masami Tanaka
1   Gastroenterology, Toranomon Hospital, minato-ku, Japan
,
Shu Hoteya
1   Gastroenterology, Toranomon Hospital, minato-ku, Japan
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Abstract

Background and study aims Endoscopic submucosal dissection (ESD) is sometimes challenging because of stenosis and scarring. We examined the use of an ultrathin endoscope for esophageal ESD, which is difficult using conventional endoscopes.

Patients and methods A designated transparent hood and ESD knife for ultrathin endoscopes have been developed and clinically introduced. Esophageal ESD was performed on 303 lesions in 220 patients in our hospital from February 2021 to February 2023. Of them, an ultrathin endoscope was used on 26 lesions in 23 cases. The safety and utility of an ultrathin endoscope in esophageal ESD were retrospectively verified.

Results All 26 lesions were resected en bloc, and serious complications such as perforation, massive bleeding, or pneumonia, were not observed. Lesions were found on the anal side of the stenosis and over the scarring in 38.6% (10/26) and 50% (13/26) of participants, respectively. Moreover, 46.2% of participants (12/26) had lesions on the cervical esophagus. The total procedure time was 64.1 ± 37.7 minutes, but the average time from oral incision to pocket creation was 121.2 ± 109.9 seconds.

Conclusions Ultrathin endoscopes may be useful for difficult esophageal ESD.

Keywords

Endoscopy Upper GI Tract - Endoscopic resection (ESD, EMRc, ...) - Pediatric endoscopy - Benign strictures


Publication History

Received: 30 August 2023

Accepted after revision: 07 August 2024

Article published online:
10 September 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Kim JS, Kim BW, Shin IS. Efficacy and safety of endoscopic submucosal dissection for superficial squamous esophageal neoplasia: a meta-analysis. Dig Dis Sci 2014; 59: 1862-1869
    CrossrefPubMedSearch in Google Scholar
  • 2 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: 255-264
    CrossrefPubMedSearch in Google Scholar
  • 3 Fukuhara M, Urabe Y, Oka S. et al. Outcomes of endoscopic submucosal dissection in patients who develop metachronous superficial esophageal squamous cell carcinoma close to a post-endoscopic submucosal dissection scar. Esophagus 2023; 20: 124-133
    CrossrefPubMedSearch in Google Scholar
  • 4 Ariyoshi R, Toyonaga T, Tanaka S. et al. Clinical outcomes of endoscopic submucosal dissection for superficial esophageal neoplasms extending to the cervical esophagus. Endoscopy 2018; 50: 613-617
    Thieme ConnectPubMedSearch in Google Scholar
  • 5 Iizuka T, Kikuchi D, Hoteya S. et al. Efficacy and safety of endoscopic submucosal dissection for superficial cancer of the cervical esophagus. Endosc Int Open 2017; 5: E736-E741
    Thieme ConnectPubMedSearch in Google Scholar
  • 6 Kawai T, Takagi Y, Yamamoto K. et al. Narrow-band imaging on screening of esophageal lesions using an ultrathin transnasal endoscopy. J Gastroenterol Hepatol 2012; 27: 34-39
    CrossrefPubMedSearch in Google Scholar
  • 7 Khurelbaatar T, Miura Y, Osawa H. et al. Improved detection of early gastric cancer with linked color imaging using an ultrathin endoscope: a video-based analysis. Endosc Int Open 2022; 10: E644-E652
    Thieme ConnectPubMedSearch in Google Scholar
  • 8 Nakamura M, Shibata T, Tahara T. et al. Usefulness of transnasal endoscopy where endoscopic submucosal dissection is difficult. Gastric Cancer 2011; 14: 378-384
    CrossrefPubMedSearch in Google Scholar
  • 9 Ono K, Ohata K, Kimoto Y. et al. A case of early esophageal cancer with pharyngeal stenosis treated by endoscopic submucosal multi-tunnel dissection using an ultra-thin endoscope. Endoscopy 2023; 55: E1-E2
    Thieme ConnectPubMedSearch in Google Scholar
  • 10 Kikuchi D, Tanaka M, Nakamura S. et al. Feasibility of ultrathin endoscope for esophageal endoscopic submucosal dissection. Endosc Int Open 2021; 9: E606-E609
    Thieme ConnectPubMedSearch in Google Scholar
  • 11 Koseki M, Kikuchi D, Odagiri H. et al. Possibility of ultrathin endoscopy in radial incision and cutting for esophageal strictures. VideoGIE GIE. VideoGIE 2022; 7: 358-360
    CrossrefPubMedSearch in Google Scholar
  • 12 Ogasawara N, Kikuchi D, Inoshita N. et al. Metachronous carcinogenesis of superficial esophagus squamous cell carcinoma after endoscopic submucosal dissection: incidence and risk stratification during long-term observation. Esophagus 2021; 18: 806-816
    CrossrefPubMedSearch in Google Scholar
  • 13 Ogasawara N, Kikuchi D, Tanaka M. et al. Comprehensive risk evaluation for metachronous carcinogenesis after endoscopic submucosal dissection of superficial pharyngeal squamous cell carcinoma. Esophagus 2022; 19: 460-468
    CrossrefPubMedSearch in Google Scholar
  • 14 Yamaguchi N, Isomoto H, Nakayama T. et al. Usefulness of oral prednisolone in the treatment of esophageal stricture after endoscopic submucosal dissection for superficial esophageal squamous cell carcinoma. Gastrointest Endosc 2011; 73: 1115-1121
    CrossrefPubMedSearch in Google Scholar
  • 15 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: 1007-1011
    Thieme ConnectPubMedSearch in Google Scholar
  • 16 Iizuka T, Kikuchi D, Yamada A. et al. Polyglycolic acid sheet application to prevent esophageal stricture after endoscopic submucosal dissection for esophageal squamous cell carcinoma. Endoscopy 2015; 47: 341-344
    Thieme ConnectPubMedSearch in Google Scholar
  • 17 Tang J, Ye S, Ji X. et al. Deployment of carboxymethyl cellulose sheets to prevent esophageal stricture after full circumferential endoscopic submucosal dissection: A porcine model. Dig Endosc 2018; 30: 608-615
    CrossrefPubMedSearch in Google Scholar
  • 18 Ohki T, Yamato M, Ota M. et al. Prevention of esophageal stricture after endoscopic submucosal dissection using tissue-engineered cell sheets. Gastroenterology 2012; 143: 582-588.e2
    CrossrefPubMedSearch in Google Scholar
  • 19 Takezawa T, Hayashi Y, Shinozaki S. et al. The pocket-creation method facilitates colonic endoscopic submucosal dissection (with video). Gastrointest Endosc 2019; 89: 1045-1053
    CrossrefPubMedSearch in Google Scholar