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The efficacy and safety of snare traction-assisted endoscopic submucosal dissection for circumferential superficial esophageal cancer

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Abstract

Objective

This study aims to investigate the efficacy and safety of snare traction-assisted endoscopic submucosal dissection (ESD) for the management of circumferential superficial esophageal cancer.

Methods

A total of 68 patients who underwent ESD for circumferential superficial esophageal cancer were included in this study. All the patients were divided into two groups based on whether the snare traction was used or not; the snare traction group (S-ESD, group n = 35) and the control group (C-ESD, group n = 33).

Results

There was no significant difference in the size of the resected area between the groups [21.98 (18.30, 27.00) cm2 vs 24.00 (15.28, 30.72) cm2, P = 0.976]. The snare traction group had a shorter dissection time [92.00 (74.00, 121.00) min vs 110.00 (92.50, 137.00) min, P = 0.017] and a faster resection speed [0.28 ± 0.13 cm2/min vs 0.22 ± 0.11cm2/min, P = 0.040] compared to the control group. There were no statistically significant differences between the two groups in terms of hospital stay, cost, en bloc resection rate, R0 resection rate, curative resection rate, bleeding rate, perforation rate, stricture rate, and recurrence rate (P > 0.05).

Conclusion

Snare traction-assisted ESD is a safe and efficient approach for the treatment of circumferential superficial esophageal cancer. Its advantages includes shorter procedure so the anesthesia requirement, clear operative filed view, improved mucosal dissection efficiency, simple, and easily accessible equipment.

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Acknowledgements

The authors would like to thank Prof. Bingrong Liu and Dr. Saif Ullah for their help in revising this manuscript.

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Author notes

  1. Nan Dai and Saif Ullah author shares co-first authorship.

Authors and Affiliations

  1. Department of Gastroenterology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, China

    Nan Dai, Saif Ullah, Jingwen Zhang, Xiaoyu Wan, Shanshan Zhu, Ping Liu, Changqing Guo & Xinguang Cao

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  1. Nan Dai
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  2. Saif Ullah
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Contributions

Conception and design of the work: Nan Dai, Changqing Guo and Xinguang Cao. Data collection and analysis: Nan Dai, Jingwen Zhang, Xiaoyu Wan and Ping Liu. Drafting or revising the work: Nan Dai, Saif Ullah, Shanshan Zhu and Ping Liu. Approval of the final version to be published: Xinguang Cao and Changqing Guo. Agreement to be accountable for all aspects of the work: Xinguang Cao.

Corresponding authors

Correspondence to Changqing Guo or Xinguang Cao.

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Disclosures

Authors declare no conflict of interests for this article. Nan Dai, Saif Ullah, Jingwen Zhang, Xiaoyu Wan, Shanshan Zhu, Ping Liu, Changqing Guo and Xinguang Cao have no conflicts of interest or financial ties to disclose.

Ethical approval

The protocol was approved by The First Affiliated Hospital of Zhengzhou University (No. 2022-KY-1190-001) and informed consent was waived. All the authors have followed the applicable ethical standards to maintain the research integrity without any duplication, fraud or plagiarism issues.

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Dai, N., Ullah, S., Zhang, J. et al. The efficacy and safety of snare traction-assisted endoscopic submucosal dissection for circumferential superficial esophageal cancer. Surg Endosc 38, 3329–3336 (2024). https://doi.org/10.1007/s00464-024-10859-y

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  • DOI: https://doi.org/10.1007/s00464-024-10859-y

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