[Endoscopic mucosal resection for the treatment of superficial adenocarcinima developed on the Barrett's mucosa].
We present a new technique of endoscopic mucosal resection for the treatment of extended superficial lesions of the esophagus such as early squamous cell carcinoma, high grade intraepithelial neoplasia or early adenocarcinoma arising in Barrett's esophagus. A modified rigid esophagoscope has been designed. A large mucosal area is sucked against a perforated 180 degrees window. Mucosal resection is performed by an electrical wire loop at a constant depth of 1 +/- 0,1 mm. The resected surface varies from 4 to 12 cm2. Circumferential resection consists of two opposite hemi-circumferential resections. The resection yields one or two specimens only for histological study allowing easy orientation and analysis of the resection margins. The deep resection margin is precisely located at the submucosal level, a prerequisite for a safe resection of T1a cancers.
Jaquet
Y
Y
Service d'ORL et chirurgie cervico-faciale, CHUV, Lausanne. yves.jaquet@hospvd.ch
Pilloud
R
R
Grosjean
P
P
Radu
A
A
Monnier
P
P
D000230:Adenocarcinoma / Q000209:etiology / Q000601:surgery*; D001471:Barrett Esophagus / Q000150:complications*; D002294:Carcinoma, Squamous Cell / Q000209:etiology / Q000601:surgery*; D004724:Endoscopy / Q000379:methods*; D004938:Esophageal Neoplasms / Q000209:etiology / Q000601:surgery*; D006801:Humans; D009092:Mucous Membrane / Q000601:surgery