title: [Narrow band imaging versus iodine staining for margin determination of early esophageal cancer during endoscopic submucosal dissection].
abstract: OBJECTIVE
  To compare the clinical value of narrow band imaging (NBI) and iodine staining for margin determination of early esophageal cancer during endoscopic submucosal dissection (ESD).
  
  
  METHODS
  Clinical data of 87 patients with early esophageal cancers undergoing endoscopic submucosal dissection (ESD) were analyzed retrospectively. Patients were assigned to NBI group and iodine staining group according to the staining method before ESD operation. Clinicopathological features, esophageal spasm ratio, operation time, en bloc resection rate, complications, local recurrence, and distant metastases were compared between the two groups.
  
  
  RESULTS
  There were 37 patients in NBI group while 50 patients in iodine staining group. Location and size of the lesions between two groups were not significantly different. The ratio of moderate-severe esophageal spasm in NBI group was significantly lower as compared to iodine staining group [10.8%(4/37) vs. 32.0%(16/50), P<0.05]. The average operation time in NBI group was significantly shorter than that in iodine staining group [(42.2±19.5) min vs. (53.3±30.9) min, P<0.05). All the tumors were resected in an en bloc fashion and the R0 resection rate was 100%. Perforations in 2 patients and delayed bleeding in 1 patient were successfully treated by endoscopic methods. Esophageal strictures occurred in 3 patients of NBI group and 4 patients of iodine staining group, who were treated by endoscopic dilation and retrievable stents. During mean 13.2 months (range 4 to 20 months) follow-up periods, local recurrence occurred in 2 patients of NBI group and 2 patients of iodine staining group. These patients received ESD or other surgery.
  
  
  CONCLUSIONS
  Compared with iodine staining, using NBI for margin determination of early esophageal cancer during ESD is more convenient and fast because of distinctly lower degree of esophageal spasm.
authors.affiliation: Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China. zhou.pinghong@zs-hospital.sh.cn.
authors.forename: Wei-feng
authors.initials: WF
authors.lastname: Chen
authors.forename: Quan-lin
authors.initials: QL
authors.lastname: Li
authors.forename: Li-qing
authors.initials: LQ
authors.lastname: Yao
authors.forename: Mei-dong
authors.initials: MD
authors.lastname: Xu
authors.forename: Shi-yao
authors.initials: SY
authors.lastname: Chen
authors.forename: Yi-qun
authors.initials: YQ
authors.lastname: Zhang
authors.forename: Yun-shi
authors.initials: YS
authors.lastname: Zhong
authors.forename: Li-li
authors.initials: LL
authors.lastname: Ma
authors.forename: Wen-zheng
authors.initials: WZ
authors.lastname: Qin
authors.forename: Jian-wei
authors.initials: JW
authors.lastname: Hu
authors.forename: Ming-yan
authors.initials: MY
authors.lastname: Cai
authors.forename: Ping-hong
authors.initials: PH
authors.lastname: Zhou
mesh_terms: D000328:Adult; D000368:Aged; D004938:Esophageal Neoplasms / Q000473:pathology* / Q000601:surgery*; D004945:Esophagoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D007455:Iodine; D008297:Male; D008875:Middle Aged; D062048:Narrow Band Imaging; D012189:Retrospective Studies; D013194:Staining and Labeling
chemical_list: D007455:Iodine