title: Endoscopic submucosal dissection for superficial esophageal cancer with near-circumferential lesions: our experience with 40 patients.
abstract: BACKGROUND
  Nowadays, there are few reports indicating whether early esophageal cancers (EsC) with near-circumferential lesions are still appropriate for the endoscopic submucosal dissection (ESD) procedure.
  
  
  METHODS
  Between November 2009 and December 2013, a total of 40 patients with early esophageal cancers were treated with ESD. The characteristics of the patients, the ESD procedure variables, the rates of en bloc resection, and the major complications were evaluated. The outcomes listed were reliably followed up, and postoperative endoscopic balloon dilation was conducted to treat the esophageal strictures.
  
  
  RESULTS
  A total of 40 patients with superficial esophageal cancers were treated with ESD procedure. The extent of the lesions as a proportion of the whole circumference of the esophageal lumen ranged from three-quarters (18/40) to four-fifths (4/40) and complete circumference (18/40). The median longitudinal diameter of the lesions was 50 mm. The median procedure time was 92.5 min (range, 70-125 min). The en bloc resection rate was 100 % (40/40). Immediate bleeding, perforation, and postoperative stenosis were noted in 7.5 (3/40), 7.5 (3/40), and 45 % (18/40) of the patients. The median number of endoscopic balloon dilations (EBDs) was 4 (range 1-14). Additional surgical treatment was performed in 2 cases, and local recurrence was detected in 1 patient (2.5 %). 2 patients (5 %) died of EsC 3 months after ESD.
  
  
  CONCLUSIONS
  These data will greatly expand the criteria for the use of ESD in esophageal cancer and increase the number of patients eligible for endoscopic treatment and the acceptance of the ESD procedure.
authors.affiliation: Department of Gastroenterology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Tang
authors.forename: Jian-Ying
authors.initials: JY
authors.lastname: Bai
authors.forename: Xiao-Yan
authors.initials: XY
authors.lastname: Zhao
authors.forename: Chao-Qiang
authors.initials: CQ
authors.lastname: Fan
authors.forename: Xin
authors.initials: X
authors.lastname: Yang
authors.forename: Lei
authors.initials: L
authors.lastname: Deng
authors.forename: Shi-Ming
authors.initials: SM
authors.lastname: Yang
authors.forename: Jing
authors.initials: J
authors.lastname: Yu
mesh_terms: D000328:Adult; D000368:Aged; D004106:Dilatation; D004938:Esophageal Neoplasms / Q000601:surgery*; D004940:Esophageal Stenosis / Q000209:etiology / Q000628:therapy; D004945:Esophagoscopy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000601:surgery*; D061646:Operative Time; D011183:Postoperative Complications