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. 2022 Nov;36(11):8371-8378.
doi: 10.1007/s00464-022-09289-5. Epub 2022 Jul 18.

Comparison between endoscopic submucosal tunnel dissection and endoscopic submucosal dissection for superficial neoplasia at esophagogastric junction: a case-matched controlled study of a single center from China

Bo-Zong Shao #  1 , Ning-Li Chai #  1 , Long-Song Li  1 , Sha-Sha Wang  1 , Xiu-Xue Feng  1 , Nan-Jun Wang  1 , Zan-Tao Wang  1 , Sheng-Zhen Liu  1 , En-Qiang Linghu  2
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Comparison between endoscopic submucosal tunnel dissection and endoscopic submucosal dissection for superficial neoplasia at esophagogastric junction: a case-matched controlled study of a single center from China

Bo-Zong Shao et al. Surg Endosc. 2022 Nov.

Abstract

Background: So far, little evidence is available for the comprehensive comparison of endoscopic submucosal tunnel dissection (ESTD) with endoscopic submucosal dissection (ESD) for the treatment of superficial neoplasia at esophagogastric junction (EGJ).

Methods: EGJ superficial neoplasia patients with ESTD treatment between January, 2021 and August, 2020 were retrospectively reviewed and individually matched at 1:1 ratio with those with ESD treatment according to lesion size, specimen area and lesion location, forming ESTD and ESD group, respectively. A sample size of 17 patients was collected for each group. Treatment outcomes including resection time, specimen area, and resection speed as well as occurrence of complications were evaluated.

Results: Compared with ESD group, ESTD group got shorter resection time (111.00 ± 11.70 min for ESD group vs. 71.59 ± 6.18 min for ESTD group, p = 0.008) and faster section speed (0.23 ± 0.03 cm2/min for ESD group vs. 0.37 ± 0.06 cm2/min for ESTD group, p = 0.012). No complication was found to occur in ESTD group, while 1 patient with MP damage and 1 with delayed bleeding was found in ESD group.

Conclusion: For the treatment of EGJ superficial neoplasia, ESTD is a safer and more effective and reliable endoscopic technique compared with ESD.

Keywords: Carcinoma; Endoscopic submucosal dissection; Endoscopic submucosal tunnel dissection; Esophagogastric junction; Superficial neoplasia.

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