[Minimal invasive treatment of early esophageal cancer and its precancerous lesion: endoscopic mucosal resection using transparent cap-fitted endoscope].
OBJECTIVE
To explore the effect of endoscopic esophageal mucosal resection using transparent cap-fitted endoscope to treat early esophageal cancer and severe hyperplasia, precancerous lesion of esophageal cancer.


METHODS
Endoscopic esophageal mucosal resection were performed with transparent-cap technique on 29 cases of early esophageal cancer and 42 cases of severe hyperplasia, and the residual lesions were treated by Argon plasma coagulation (APC). All patients were followed up by endoscopic examination one month, 4 months, and 12 months after the therapy.


RESULTS
(1) Local esophageal mucosa with the size of 21.8 mm +/- 1.02 mm x 18.2 mm +/- 1.02 mm on average was resected from 71 cases, with 88 lesions, using transparent cap-fitted endoscope. 1:1,000 saline-epinephrine at an average dose of 18 ml was injected submucosally for each lesion. (2) After the mucosectomy 5 cases had bleeding which was controlled successfully by compression, local injection of saline-epinephrine, and APC. None case suffered from perforation. Stenosis was found in 4 cases after mucosal resection, in three of which the extent of resected mucosa exceeded 3/4 of the esophageal circumference. Water-balloon dilator was used once a month for 3 - 4 times since one month after mucosal resection. All cases were cured. (3) The lesions of 58 cases (81.2%) were completely resected, and the remaining cases had residual lesions that were treated by APC. Three cases of early cancer and 2 cases of severe atypical hyperplasia were discovered endoscopically 4 months after resection and were cured by APC. (4) All cases survived without any discomfort after a follow-up of 4.6 months on average.


CONCLUSIONS
Safe, simple, minimally invasive and effective on early esophageal cancer and precancerous lesion, endoscopic esophageal mucosal resection (EEMR) is promising clinically.
Wang
Gui-qi
GQ
Department of Endoscopy, Cancer Hospital (Institute), Chinese Academy of Medical Sciences, Beijing 100021, China.
Wei
Wen-qiang
WQ
Hao
Chang-qing
CQ
Zhang
Xiao-hua
XH
Lai
Shao-qing
SQ
Yu
Gui-xiang
GX
Ju
Feng-huan
FH
Ma
Yue-hua
YH
Qiao
You-lin
YL
Dong
Zhi-wei
ZW
Wang
Guo-qing
GQ
D000328:Adult; D000368:Aged; D004938:Esophageal Neoplasms / Q000401:mortality / Q000523:psychology / Q000601:surgery*; D004945:Esophagoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D011230:Precancerous Conditions / Q000401:mortality / Q000523:psychology / Q000601:surgery*; D011788:Quality of Life; D015996:Survival Rate