ABSTRACT
Background and purpose:Endoscopic treatment is a promising therapeutic option for superifcial lesions throughout the gastrointestinal tract, this study was aimed to evaluate the efficacy of endoscopic resection (ER) using the new Duette multiband mucosectomy kit (DT-6) on treating esophageal disease. Methods:Since Jun. 2011, ER using DT-6 has been performed on 100 patients in a tertiary medical center. Data from those who have been followed up for over 6 months was analyzed. ER and esophagectomy were compared on treating high grade dysplasia (HGD) lesions and early esophageal cancer. Results:From Jun. 2011 to Jan. 2012, a total of 32 patients with esophageal lesions underwent 34 ER using DT-6 (22 male and 10 female, mean age 59.0 years, range 25 to 83 years). There were (3.4±1.0) specimen resected per operation, and the average greatest diameter was (11.8±2.7)mm. Intraoperative blood loss was (5.45±1.47)mL. The median follow-up period was 8.2 months with a 100%half-year-follow-up rate. Except one pneumothorax occurred during one endoscopic submucosal dissection (ESD), no other complications happened. When Comparing ER and esophagectomy on treating HGD and early esophageal cancer, ER showed advantages in terms of operation time, intraoperative blood loss, hospital stay and complications. Conclusion:ER using DT-6 is safe, simple, minimally invasive and effective for esophageal disease. Prospective study and long follow-up are needed to compare endoscopic resection and esophagectomy for HGD and early esophagus cancer.
ABSTRACT
Objective To explore the feasibility and short-term efficacy of combined use of laparoscopic and thoracoscopic Ivor Lewis esophagectomy for the treatment of esophageal carcinoma.Methods A case of esophageal carcinoma was treated in our hospital in December 2007.Five trocars were used via laparoscopy to free the stomach and create a tube-like stomach.Afterwards,thoracoscopy was carried out via 4 trocars to remove the lesion and open the diaphragm,and then the tube-like stomach was pulled into the chest cavity and anastomosed to the chest wall.Results The operation time was 330 min,and the intraoperative blood loss was 200 ml.The lesion was removed completely with negative cutting edges.Postoperative pathological examination showed squamous cell carcinoma(stage T2N0M0).Follow-up was available for 3 months,during which no recurrence was found.Conclusion Laparoscopic and thoracoscopic Ivor Lewis esophagectomy is feasible and safe for the treatment of esophageal carcinoma.
ABSTRACT
The three-field lymphadenectomy for carcinoma of the esophagus remains debatable. There are several aspects that the debate focuses on. Firstly, should the positive cervical lymph nodes be considered a regional(N1) or a distant( M1) site of disease for tumors of esophagus? Secondly, can the extended lymphadenectomy prolong survival? Thirdly, the increase in the morbidity rates.