Effectiveness of endoscopic mucosal resection with submucosal saline injection technique for superficial squamous carcinomas of the esophagus.
BACKGROUND
Intraepithelial cancers (m1 cancer) and cancers that penetrate the basement membrane but do not approach the muscularis mucosae (m2 cancer) do not have lymph node metastasis and thus can be removed completely with mucosal resection. Therefore, in this study, the effectiveness of endoscopic mucosal resection with submucosal saline injection for removal of superficial esophageal cancers was investigated prospectively.


METHODS
Twenty-five superficial esophageal cancers in 21 patients were removed with submucosal saline injection. When it was thought that a tumor had not been completely resected en bloc, it was removed completely in piecemeal fashion. Endoscopy was repeated 1, 3, 6, 12 months or more after endoscopic resection.


RESULTS
All superficial esophageal cancers were completely removed: 18 (72%) en bloc and 7 (28%) by piecemeal resection. No recurrence was found during a mean observation period of 2.0 years (range 0.8 to 3.6) after resection. Bleeding occurred in 5 cases (24%) during or after resection but was successfully treated with the endoscopic alginate or thrombin spray technique. There was no perforation.


CONCLUSIONS
Endoscopic mucosal resection with submucosal saline injection is effective for removal of superficial cancers of the esophagus.
Narahara
H
H
Departments of Gastroenterology and Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan. narahara@d1.dion.ne.jp
Iishi
H
H
Tatsuta
M
M
Uedo
N
N
Sakai
N
N
Yano
H
H
Otani
T
T
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery*; D004945:Esophagoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology / Q000601:surgery; D011336:Probability; D011446:Prospective Studies; D012965:Sodium Chloride / Q000008:administration & dosage*; D016896:Treatment Outcome
D012965:Sodium Chloride