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Barrett’s adenocarcinoma with esophageal varices successfully treated by endoscopic submucosal dissection with direct varices coagulation

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Abstract

A 67-year-old Japanese man with alcoholic cirrhosis underwent esophagogastroduodenoscopy (EGD), which revealed a 15-mm elevated lesion on the esophagogastric junction (EGJ). Endoscopic findings suggested that the lesion was an intramucosal cancer present on the esophageal varices. The location of the lesion at EGJ caused difficulties in endoscopic injection sclerotherapy and endoscopic variceal ligation for esophageal varices before esophageal endoscopic submucosal dissection (ESD). Direct varices coagulation treatment was therefore selected during ESD. Coagulation of bared varices with hemostatic forceps after mucosal incision enabled performing ESD without serious bleeding. 2 months afterwards, the patient underwent EGD, with no esophageal varices or carcinoma recurrence. Direct varices coagulation was effective for ESD of Barrett adenocarcinoma with esophageal varices.

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References

  1. Tachibana M, Kotoh T, Kinugasa S, et al. Esophageal cancer with cirrhosis of the liver: results of esophagectomy in 18 consecutive patients. Ann Surg Oncol. 2000;7:758–63.

    Article  CAS  Google Scholar 

  2. Trivin F, Boucher E, Vauleon E, et al. Management of esophageal carcinoma associated with cirrhosis: a retrospective case-control analysis. J Oncol. 2009;2009:173421.

    Article  Google Scholar 

  3. 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;59:1862–9.

    Article  Google Scholar 

  4. Mitsuishi T, Goda K, Imazu H, et al. Superficial esophageal carcinomas on esophageal varices treated with endoscopic submucosal dissection after intravariceal endoscopic injection sclerotherapy. Gastroenterol Endosc. 2013;55:2189–96.

    Google Scholar 

  5. Tsou YK, Liu CY, Fu KI, et al. Endoscopic submucosal dissection of superficial esophageal neoplasms is feasible and not riskier for patients with liver cirrhosis. Dig Dis Sci. 2016;61:3565–71.

    Article  Google Scholar 

  6. Sawaguchi M, Jin M, Matsuhashi T, et al. The feasibility of endoscopic submucosal dissection for superficial esophageal cancer in patients with cirrhosis (with video). Gastrointest Endosc. 2014;79:681–5.

    Article  Google Scholar 

  7. Poza Cordon J, Froilan Torres C, Burgos Garcia A, et al. Endoscopic management of esophageal varices. World J Gastrointest Endosc. 2012;4:312–22.

    Article  Google Scholar 

  8. Funakoshi K, Akiyama N, Kozakai I, et al. Successful endoscopic therapy of superficial esophageal cancer on varices in a patient with alcoholic liver cirrhosis. Dig Endosc. 2001;13:212–5.

    Article  Google Scholar 

  9. Wheeler JB, Reed CE. Epidemiology of esophageal cancer. Surg Clin N Am. 2012;92:1077–87.

    Article  Google Scholar 

  10. Domper Arnal MJ, Ferrandez Arenas A, Lanas Arbeloa A. Esophageal cancer: risk factors, screening and endoscopic treatment in Western and Eastern countries. World J Gastroenterol WJG. 2015;21:7933–43.

    Article  Google Scholar 

  11. Amadi C, Gatenby P. Barrett's oesophagus: Current controversies. World J Gastroenterol WJG. 2017;23:5051–67.

    Article  Google Scholar 

  12. Kawada K, Kawano T, Nakajima Y. Diagnosis of Barrett’s esophagus and Barrett’s esophageal cancer by endoscopy. Gastroenterol Endosc. 2017;59:70–80.

    Google Scholar 

  13. Westerterp M, Koppert LB, Bunkens CJ. Outcome of surgical treatment for early adenocarcinoma of the esophagus or gastro-esophageal junction. Virchows Arch. 2005;446:497–504.

    Article  Google Scholar 

  14. Liu L, Hofstetter WL, Rashid A. Significance of the depth of tumor invasion and lymph node metastasis in superficially invasive (T1) esophageal adenocarcinoma. Am J Surg Pathol. 2005;29:1079–85.

    PubMed  Google Scholar 

  15. Oh DS, Hagen JA, Chandrasoma PT. Clinical biology and surgical therapy of intramucosal adenocarcinoma of the esophagus. J Am Coll Surg. 2006;203:152–61.

    Article  Google Scholar 

  16. Abraham SC, Krasinskas AM, Correa AM. Duplication of the muscularis mucosae in barrett esophagus: an underrecognized feature and its implication for staging of adenocarcinoma. Am J Surg Pathol. 2007;31:1719–25.

    Article  Google Scholar 

  17. Ishihara R, Oyama T, Abe S. Risk of metastasis in adenocarcinoma of the esophagus: a multicenter retrospective study in a Japanese population. J Gastroenterol. 2017;52:800–8.

    Article  Google Scholar 

  18. Barbour AP, Jones M, Brown I. Risk stratification for early esophageal adenocarcinoma: analysis of lymphatic spread and prognostic factors. Ann Surg Oncol. 2010;17:2494–502.

    Article  Google Scholar 

  19. Bolton WD, Hofstetter WL, Francis AM. Impact of tumor length on long-term survival of pT1 esophageal adenocarcinoma. J Thorac Cardiovasc Surg. 2009;138:831–6.

    Article  Google Scholar 

  20. Friedman LS. Surgery in the patient with liver disease. Trans Am Clin Climatol Assoc. 2010;121:192–204 (discussion 205).

    PubMed  PubMed Central  Google Scholar 

Download references

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Osaka Saiseikai Nakatsu Hospital, 2-10-39 Shibata, Kita-ku, Osaka, 530-0012, Japan

    Chise Ueda, Tetsuya Yosizaki, Norio Katayama, Norihiro Okamoto, Hiroki Hashimura, Masanori Matsumoto, Megumi Takagi, Seitaro Ikeoka, Kenji Momose, Takaaki Eguchi, Hiroshi Yamashita & Akihiko Okada

  2. Department of Gastroenterology and Hepatology, Kobe University School of Medicine, Kobe, Japan

    Chise Ueda

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  1. Chise Ueda
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  2. Tetsuya Yosizaki
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  3. Norio Katayama
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  4. Norihiro Okamoto
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Correspondence to Tetsuya Yosizaki.

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All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Ueda, C., Yosizaki, T., Katayama, N. et al. Barrett’s adenocarcinoma with esophageal varices successfully treated by endoscopic submucosal dissection with direct varices coagulation. Clin J Gastroenterol 13, 178–181 (2020). https://doi.org/10.1007/s12328-019-01048-9

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  • DOI: https://doi.org/10.1007/s12328-019-01048-9

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