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Revisiting Barrett's Esophagus pp 147–158Cite as

Endoscopic Resections: EMR and ESD

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Abstract

Endoscopic resection emerged as a less invasive alternative for treatment of esophageal neoplasm associated with Barrett’s esophagus (BE). The Western guidelines recommend endoscopic resection for all visible early esophageal neoplasms for staging as well as treatment. Endoscopic mucosal resection (EMR) is currently the most commonly available treatment of BE associated neoplasm particularly in the West, because of technically easy and simple procedure. Endoscopic submucosal dissection (ESD) can provide en bloc resection and thus a more complete assessment of histology regardless of the size and location. R0 resection of ESD is higher than that of EMR; however, this has not translated into clinically meaningful benefits to date. Thus, ESD for BE-related neoplasia is commonly performed in some Asian countries; however, it is still not yet ready for widespread clinical use. Further prospective studies are warranted to clarify the effectiveness of ESD for esophageal neoplasm associated with BE.

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References

  1. Seder CW, Raymond DP, Wright CD, Gaissert HA, Chang AC, Clinton S, et al. The Society of Thoracic Surgeons General Thoracic Surgery Database 2017 Update on Outcomes and Quality. Ann Thorac Surg. 2017;103(5):1378–83.

    Article  Google Scholar 

  2. Orringer MB, Marshall B, Chang AC, Lee J, Pickens A, Lau CL. Two thousand transhiatal esophagectomies: changing trends, lessons learned. Ann Surg. 2007;246(3):363–72; discussion 72–4.

    Article  Google Scholar 

  3. McCulloch P, Ward J, Tekkis PP, ASCOT group of surgeons, British Oesophago-Gastric Cancer Group. Mortality and morbidity in gastro-oesophageal cancer surgery: initial results of ASCOT multicentre prospective cohort study. BMJ. 2003;327(7425):1192–7.

    Article  Google Scholar 

  4. Birkmeyer JD, Stukel TA, Siewers AE, Goodney PP, Wennberg DE, Lucas FL. Surgeon volume and operative mortality in the United States. N Engl J Med. 2003;349(22):2117–27.

    Article  CAS  Google Scholar 

  5. Dunbar KB, Spechler SJ. The risk of lymph-node metastases in patients with high-grade dysplasia or intramucosal carcinoma in Barrett’s esophagus: a systematic review. Am J Gastroenterol. 2012;107(6):850–62; quiz 63.

    Article  Google Scholar 

  6. Manner H, Pech O, Heldmann Y, May A, Pohl J, Behrens A, et al. Efficacy, safety, and long-term results of endoscopic treatment for early stage adenocarcinoma of the esophagus with low-risk sm1 invasion. Clin Gastroenterol Hepatol. 2013;11(6):630–5; quiz e45

    Article  Google Scholar 

  7. Shaheen NJ, Falk GW, Iyer PG, Gerson LB. ACG Clinical Guideline: diagnosis and management of Barrett’s Esophagus. Am J Gastroenterol. 2016;111(1):30–50; quiz 1.

    Article  CAS  Google Scholar 

  8. Weusten B, Bisschops R, Coron E, Dinis-Ribeiro M, Dumonceau JM, Esteban JM, et al. Endoscopic management of Barrett’s esophagus: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement. Endoscopy. 2017;49(2):191–8.

    Article  Google Scholar 

  9. Ishihara R, Oyama T, Abe S, Takahashi H, Ono H, Fujisaki J, et al. Risk of metastasis in adenocarcinoma of the esophagus: a multicenter retrospective study in a Japanese population. J Gastroenterol. 2016;52(7):800–8.

    Article  Google Scholar 

  10. Oda I, Abe S, Kusano C, Suzuki H, Nonaka S, Yoshinaga S, et al. Correlation between endoscopic macroscopic type and invasion depth for early esophagogastric junction adenocarcinomas. Gastric Cancer. 2011;14(1):22–7.

    Article  Google Scholar 

  11. Qumseya BJ, Brown J, Abraham M, White D, Wolfsen H, Gupta N, et al. Diagnostic performance of EUS in predicting advanced cancer among patients with Barrett's esophagus and high-grade dysplasia/early adenocarcinoma: systematic review and meta-analysis. Gastrointest Endosc. 2015;81(4):865–74. e2

    Article  Google Scholar 

  12. Thota PN, Sada A, Sanaka MR, Jang S, Lopez R, Goldblum JR, et al. Correlation between endoscopic forceps biopsies and endoscopic mucosal resection with endoscopic ultrasound in patients with Barrett’s esophagus with high-grade dysplasia and early cancer. Surg Endosc. 2017;31(3):1336–41.

    Article  Google Scholar 

  13. Ell C, May A, Gossner L, Pech O, Gunter E, Mayer G, et al. Endoscopic mucosal resection of early cancer and high-grade dysplasia in Barrett’s esophagus. Gastroenterology. 2000;118(4):670–7.

    Article  CAS  Google Scholar 

  14. May A, Gossner L, Behrens A, Kohnen R, Vieth M, Stolte M, et al. A prospective randomized trial of two different endoscopic resection techniques for early stage cancer of the esophagus. Gastrointest Endosc. 2003;58(2):167–75.

    Article  Google Scholar 

  15. Nijhawan PK, Wang KK. Endoscopic mucosal resection for lesions with endoscopic features suggestive of malignancy and high-grade dysplasia within Barrett's esophagus. Gastrointest Endosc. 2000;52(3):328–32.

    Article  CAS  Google Scholar 

  16. Wani S, Abrams J, Edmundowicz SA, Gaddam S, Hovis CE, Green D, et al. Endoscopic mucosal resection results in change of histologic diagnosis in Barrett’s esophagus patients with visible and flat neoplasia: a multicenter cohort study. Dig Dis Sci. 2013;58(6):1703–9.

    Article  Google Scholar 

  17. Bahin FF, Jayanna M, Hourigan LF, Lord RV, Whiteman D, Williams SJ, et al. Long-term outcomes of a primary complete endoscopic resection strategy for short-segment Barrett’s esophagus with high-grade dysplasia and/or early esophageal adenocarcinoma. Gastrointest Endosc. 2016;83(1):68–77.

    Article  Google Scholar 

  18. Pech O, Behrens A, May A, Nachbar L, Gossner L, Rabenstein T, et al. Long-term results and risk factor analysis for recurrence after curative endoscopic therapy in 349 patients with high-grade intraepithelial neoplasia and mucosal adenocarcinoma in Barrett’s oesophagus. Gut. 2008;57(9):1200–6.

    Article  CAS  Google Scholar 

  19. Lada MJ, Watson TJ, Shakoor A, Nieman DR, Han M, Tschoner A, et al. Eliminating a need for esophagectomy: endoscopic treatment of Barrett esophagus with early esophageal neoplasia. Semin Thorac Cardiovasc Surg. 2014;26(4):274–84.

    Article  Google Scholar 

  20. Gotoda T. Endoscopic resection of early gastric cancer. Gastric Cancer. 2007;10:1):1–11.

    Article  Google Scholar 

  21. Saito Y, Uraoka T, Yamaguchi Y, Hotta K, Sakamoto N, Ikematsu H, et al. A prospective, multicenter study of 1111 colorectal endoscopic submucosal dissections (with video). Gastrointest Endosc. 2010;72(6):1217–25.

    Article  Google Scholar 

  22. Oyama T, Tomori A, Hotta K, Morita S, Kominato K, Tanaka M, et al. Endoscopic submucosal dissection of early esophageal cancer. Clin Gastroenterol Hepatol. 2005;7 Suppl 1:S67–70.

    Article  Google Scholar 

  23. Yamamoto H, Yahagi N, Oyama T, Gotoda T, Doi T, Hirasaki S, et al. Usefulness and safety of 0.4% sodium hyaluronate solution as a submucosal fluid “cushion” in endoscopic resection for gastric neoplasms: a prospective multicenter trial. Gastrointest Endosc. 2008;67(6):830–9.

    Article  Google Scholar 

  24. Uraoka T, Saito Y, Yamamoto K, Fujii T. Submucosal injection solution for gastrointestinal tract endoscopic mucosal resection and endoscopic submucosal dissection. Drug Des Devel Ther. 2009;2:131–8.

    PubMed  PubMed Central  Google Scholar 

  25. Draganov PV, Gotoda T, Chavalitdhamrong D, Wallace MB. Techniques of endoscopic submucosal dissection: application for the Western endoscopist? Gastrointest Endosc. 2013;78(5):677–88.

    Article  Google Scholar 

  26. Arantes V, Albuquerque W, Benfica E, Duarte DL, Lima D, Vilela S, et al. Submucosal injection of 0.4% hydroxypropyl methylcellulose facilitates endoscopic mucosal resection of early gastrointestinal tumors. J Clin Gastroenterol. 2010;44(9):615–9.

    Article  Google Scholar 

  27. Mehta N, Strong AT, Franco M, Stevens T, Chahal P, Jang S, et al. Optimal injection solution for endoscopic submucosal dissection: a randomized controlled trial of Western solutions in a porcine model. Dig Endosc. 2017;30(3):347–53.

    Article  Google Scholar 

  28. Nonaka S, Saito Y, Takisawa H, Kim Y, Kikuchi T, Oda I. Safety of carbon dioxide insufflation for upper gastrointestinal tract endoscopic treatment of patients under deep sedation. Surg Endosc. 2010;24(7):1638–45.

    Article  Google Scholar 

  29. Nonaka S, Kawaguchi Y, Oda I, Nakamura J, Sato C, Kinjo Y, et al. Safety and effectiveness of propofol-based monitored anesthesia care without intubation during endoscopic submucosal dissection for early gastric and esophageal cancers. Dig Endosc. 2015;27(6):665–73.

    Article  Google Scholar 

  30. Oyama T. Counter traction makes endoscopic submucosal dissection easier. Clin Endosc. 2012;45(4):375–8.

    Article  Google Scholar 

  31. Koike Y, Hirasawa D, Fujita N, Maeda Y, Ohira T, Harada Y, et al. Usefulness of the thread-traction method in esophageal endoscopic submucosal dissection: randomized controlled trial. Dig Endosc. 2015;27(3):303–9.

    Article  Google Scholar 

  32. Huang R, Cai H, Zhao X, Lu X, Liu M, Lv W, et al. Efficacy and safety of endoscopic submucosal tunnel dissection for superficial esophageal squamous cell carcinoma: a propensity score matching analysis. Gastrointest Endosc. 2017;86(5):831–8.

    Article  Google Scholar 

  33. Yang D, Zou F, Xiong S, Forde JJ, Wang Y, Draganov PV. Endoscopic submucosal dissection for early Barrett’s neoplasia: a meta-analysis. Gastrointest Endosc. 2017;87(6):1383–93.

    Article  Google Scholar 

  34. Yang D, Coman RM, Kahaleh M, Waxman I, Wang AY, Sethi A, et al. Endoscopic submucosal dissection for Barrett’s early neoplasia: a multicenter study in the United States. Gastrointest Endosc. 2017;86(4):600–7.

    Article  Google Scholar 

  35. Subramaniam S, Chedgy F, Longcroft-Wheaton G, Kandiah K, Maselli R, Seewald S, et al. Complex early Barrett’s neoplasia at 3 Western centers: European Barrett’s Endoscopic Submucosal Dissection Trial (E-BEST). Gastrointest Endosc. 2017;86(4):608–18.

    Article  Google Scholar 

  36. Guo HM, Zhang XQ, Chen M, Huang SL, Zou XP. Endoscopic submucosal dissection vs endoscopic mucosal resection for superficial esophageal cancer. World J Gastroenterol. 2014;20(18):5540–7.

    Article  Google Scholar 

  37. Terheggen G, Horn EM, Vieth M, Gabbert H, Enderle M, Neugebauer A, et al. A randomised trial of endoscopic submucosal dissection versus endoscopic mucosal resection for early Barrett’s neoplasia. Gut. 2017;66(5):783–93.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Digestive Endoscopy Unit, Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan

    Seiichiro Abe & Yutaka Saito

  2. Emergency Surgical Endoscopy Unit, Piastra Endoscopica, Polo Confortini, Ospedale Borgo Trento, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy

    Filippo Catalano

Authors
  1. Seiichiro Abe
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  2. Filippo Catalano
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  3. Yutaka Saito
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Corresponding author

Correspondence to Yutaka Saito .

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Editors and Affiliations

  1. Department of Clinical Medicine and Surgery, University of Naples Federico II, School of Medicine, Naples, Italy

    Giuseppe Galloro

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Abe, S., Catalano, F., Saito, Y. (2019). Endoscopic Resections: EMR and ESD. In: Galloro, G. (eds) Revisiting Barrett's Esophagus. Springer, Cham. https://doi.org/10.1007/978-3-319-92093-1_15

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  • DOI: https://doi.org/10.1007/978-3-319-92093-1_15

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-92092-4

  • Online ISBN: 978-3-319-92093-1

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