[Esophagectomy after endoscopic submucosal dissection (ESD)].
Herein, we report 9 patients who underwent esophagectomy after endoscopic submucosal dissection (ESD) between April 2003 and December 2013. All patients were men, with a mean age of 65 years. En bloc ESD was performed, and no complications arose in any patient. The mean surgical time of esophagectomy was 323 minutes, and mean blood loss was 295 mL. Postoperative complications were present in 5 patients(anastomotic leakage in 3, pulmonary complications in 2, and recurrent laryngeal nerve palsy in 1). In a patient diagnosed with pT1b-SM1 disease after ESD, a residual tumor(pT1a-MM, N0) was detected after esophagectomy. In another patient diagnosed with pT1b-SM2 disease, lymph node metastasis was detected after esophagectomy. In all patients, curative resection was performed, and no recurrences have been observed to date. This highlights the importance of additional esophagectomy after ESD for patients with pT1b disease. Esophagectomy after ESD can be considered a valid treatment because it provides high curative rates with acceptable safety.
Dept. of Surgery, Division of Digestive Surgery, Kyoto Prefectural University of Medicine.
Yoshito
Y
Nako
Atushi
A
Shiozaki
Hitoshi
H
Fujiwara
Hirotaka
H
Konishi
Toshiyuki
T
Kosuga
Ryo
R
Morimura
Yasutoshi
Y
Murayama
Shuhei
S
Komatsu
Hisashi
H
Ikoma
Yoshiaki
Y
Kuriu
Masayoshi
M
Nakanishi
Daisuke
D
Ichikawa
Kazuma
K
Okamoto
Chouhei
C
Sakakura
Eigo
E
Otsuji
D000368:Aged; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy; D004945:Esophagoscopy; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000601:surgery; D018365:Neoplasm, Residual / Q000601:surgery; D011183:Postoperative Complications