Endoscopy 2018; 50(05): 505-510
DOI: 10.1055/s-0043-122384
Innovations and brief communications
© Georg Thieme Verlag KG Stuttgart · New York

Single- and double-tunnel endoscopic submucosal tunnel dissection for large superficial esophageal squamous cell neoplasms

Wengang Zhang*
Department of Gastroenterology, Chinese PLA General Hospital, Beijing, China
,
Yaqi Zhai*
Department of Gastroenterology, Chinese PLA General Hospital, Beijing, China
,
Ningli Chai
Department of Gastroenterology, Chinese PLA General Hospital, Beijing, China
,
Enqiang Linghu
Department of Gastroenterology, Chinese PLA General Hospital, Beijing, China
,
Huikai Li
Department of Gastroenterology, Chinese PLA General Hospital, Beijing, China
,
Xiuxue Feng
Department of Gastroenterology, Chinese PLA General Hospital, Beijing, China
› Author Affiliations
Further Information

Publication History

submitted 05 May 2017

accepted after revision 10 October 2017

Publication Date:
08 December 2017 (eFirst)

Abstract

Background and study aim Single-tunnel endoscopic submucosal tunnel dissection (ESTD) has shown promising preliminary efficacy for large superficial esophageal squamous cell neoplasms (SESCNs). This study reports the outcomes of both single- and double-tunnel ESTD for large SESCNs, and compares the efficiency of the two techniques for treating circumferential SESCNs.

Patients and methods 46 patients with large SESCNs underwent ESTD at a single hospital between October 2011 and March 2016. Relevant clinical data were retrospectively collected and analyzed.

Results For all patients, the en bloc and R0 resection rates were 95.7 % and 82.6 %, respectively. Perforation and cardiac mucosal laceration were detected in 2.2 % (1/46) and 6.5 % (3/46) of the procedures, respectively. Postoperative stenosis occurred in 12 patients (26.1 %). Of the 18 patients with circumferential lesions, those who received a double-tunnel ESTD procedure (n = 6) underwent dissection faster than those who had a single-tunnel ESTD procedure (n = 12) (0.32 vs. 0.12 cm2/min; P = 0.02).

Conclusion ESTD was effective for large SESCNs. The double-tunnel ESTD appeared to decrease operative time compared with single-tunnel ESTD for circumferential lesions.

* These authors contributed equally to this work.