title: Endoscopic submucosal multi-tunnel dissection for circumferential superficial esophageal neoplastic lesions (with videos).
abstract: OBJECTIVE
  Endoscopic submucosal tunnel dissection (ESTD) has been used for dissection of large esophageal neoplastic lesions, but there are still some technical problems in treating circumferential superficial esophageal neoplastic lesions. This study aimed to assess the efficacy and safety of endoscopic submucosal multi-tunnel dissection (ESMTD) for circumferential superficial esophageal neoplastic lesions in selected patients followed up for 1 to 12 months.
  
  
  METHODS
  From July 2014 to February 2015, the first series of 7 consecutive patients with circumferential superficial esophageal neoplastic lesions underwent ESMTD at our endoscopic center. The macroscopic types were classified according to the Paris endoscopic classification of superficial neoplastic lesions.
  
  
  RESULTS
  The average length of lesions was 6.1 cm in 7 selected patients. The operative time ranged from 69 to 169 minutes (mean 121 minutes). En bloc dissection with negative basal margins was achieved in all lesions without serious intraoperative adverse events. Esophageal stricture was observed in all patients 1 to 3 months after the operation and was relieved after a retrievable metal stent was placed or esophageal water balloon dilatation was performed; however, one patient died of cerebral infarction 2 months after ESMTD.
  
  
  CONCLUSIONS
  ESMTD is feasible, safe, and effective for the treatment of circumferential superficial esophageal neoplastic lesions in select patients.
authors.affiliation: Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Sichuan, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Gan
authors.affiliation: Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Sichuan, China.
authors.forename: Jin-Lin
authors.initials: JL
authors.lastname: Yang
authors.affiliation: Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Sichuan, China.
authors.forename: Lin-Lin
authors.initials: LL
authors.lastname: Zhu
authors.affiliation: Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Sichuan, China.
authors.forename: Yi-Ping
authors.initials: YP
authors.lastname: Wang
authors.affiliation: Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Sichuan, China.
authors.forename: Li
authors.initials: L
authors.lastname: Yang
authors.affiliation: Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Sichuan, China. Electronic address: Junchaowu_2015@sina.com.
authors.forename: Jun-Chao
authors.initials: JC
authors.lastname: Wu
mesh_terms: D000368:Aged; D004106:Dilatation; D000069916:Endoscopic Mucosal Resection / Q000379:methods*; D004938:Esophageal Neoplasms / Q000601:surgery*; D004940:Esophageal Stenosis / Q000453:epidemiology / Q000601:surgery*; D004945:Esophagoscopy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D015607:Stents