title: Endoscopic submucosal dissection for malignant esophageal lesions.
abstract: The incidence of esophageal cancer has been increasing while the prognosis remains very poor. Endoscopic submucosal dissection (ESD) was developed in Japan for en bloc resection of early gastric cancer with excellent results. The use of ESD in early squamous cell cancer (SCC) of the esophagus in Japan has been increasing with long-term results comparable to those in early gastric cancer. The use of ESD in Barrett's neoplasia in western countries has been challenged by the low complete resection rates and the risk of metachronous lesions from surrounding non-dysplastic Barrett's epithelium. Efforts to combine ESD with other treatment modalities such as radiofrequency ablation in Barrett's neoplasia and chemoradiation in SCC appear to be promising. The use of steroid therapy (local or systemic) has been demonstrated to prevent post-ESD stenosis, which is the most common complication after esophageal ESD.
authors.affiliation: Harry S. Truman Memorial Veterans Hospital, University of Missouri Hospital and Clinics, Columbia, MO, USA, hammadh@health.missouri.edu.
authors.forename: Hazem
authors.initials: H
authors.lastname: Hammad
authors.forename: Tonya
authors.initials: T
authors.lastname: Kaltenbach
authors.forename: Roy
authors.initials: R
authors.lastname: Soetikno
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery*; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D001471:Barrett Esophagus / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000601:surgery* / Q000628:therapy; D017115:Catheter Ablation / Q000379:methods; D059186:Chemoradiotherapy, Adjuvant; D003131:Combined Modality Therapy; D004210:Dissection / Q000379:methods*; D004938:Esophageal Neoplasms / Q000601:surgery*; D004940:Esophageal Stenosis / Q000517:prevention & control; D004945:Esophagoscopy / Q000379:methods*; D006801:Humans; D009092:Mucous Membrane / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control
chemical_list: D000305:Adrenal Cortex Hormones