Clinical effect of endoscopic submucosal dissection in the treatment of Siewert type Ⅱ early adenocarcinoma and precancerous lesions of esophagogastric junction
<b>Objective</b> To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) in the treatment of Siewert type Ⅱ early adenocarcinoma of the esophagogastric junction (AEG) and esophagogastric junction (EGJ) precancerous lesions. <b>Methods</b> The clinical...
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The Editorial Department of Chinese Journal of Clinical Research
2025-01-01
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| author | GUO Huiwen, HE Qibin, LIU Yang, TIE Guangxuan, CHEN Yijia |
| author_facet | GUO Huiwen, HE Qibin, LIU Yang, TIE Guangxuan, CHEN Yijia |
| author_sort | GUO Huiwen, HE Qibin, LIU Yang, TIE Guangxuan, CHEN Yijia |
| collection | DOAJ |
| description | <b>Objective</b> To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) in the treatment of Siewert type Ⅱ early adenocarcinoma of the esophagogastric junction (AEG) and esophagogastric junction (EGJ) precancerous lesions.
<b>Methods</b> The clinical data, endoscopic features, postoperative pathology, intraoperative and postoperative complications and follow-up results of 41 patients with Siewert type Ⅱ early AEG and EGJ precancerous lesions in the Department of Gastroenterology of Nanjing Jiangning Hospital from April 2020 to February 2024 were analyzed retrospectively.
<b>Results</b> The success rate of ESD operation was 100%, the complete resection rate of the lesion was 97.6%, the curative resection rate was 73.2%, the coincidence rate of endoscopic and pathological infiltration was 92.7%, and the postoperative pathological upgrade rate was 68.3%. The intraoperative complication rate was 14.6%, with 5 cases showing exposure of the local muscle layer or damage to the superficial muscle layer, and 1 case showing local submucosal fibrosis adhesion with significant bleeding. The postoperative complication rate was 9.8%, with 1 case of splenic rupture, 1 case of delayed postoperative bleeding, and 2 cases of postoperative cardiac stenosis, all of which improved after symptomatic treatment. Follow-up ranged from 2 to 44 months, with a postoperative recurrence rate of 2.3% and an all-cause mortality rate of 7.3%.
<b>Conclusion</b> ESD is a minimally invasive, safe and effective endoscopic treatment for early Siewert type Ⅱ AEG and EGJ precancerous lesions, with high complete resection rate and curative resection rate, fewer postoperative complications and no serious adverse event. |
| format | Article |
| id | doaj-art-e46a0b04d58647ac9ef2f73e06b00a46 |
| institution | DOAJ |
| issn | 1674-8182 |
| language | zho |
| publishDate | 2025-01-01 |
| publisher | The Editorial Department of Chinese Journal of Clinical Research |
| record_format | Article |
| series | Zhongguo linchuang yanjiu |
| spelling | doaj-art-e46a0b04d58647ac9ef2f73e06b00a462025-08-20T02:45:32ZzhoThe Editorial Department of Chinese Journal of Clinical ResearchZhongguo linchuang yanjiu1674-81822025-01-01381222710.13429/j.cnki.cjcr.2025.01.005Clinical effect of endoscopic submucosal dissection in the treatment of Siewert type Ⅱ early adenocarcinoma and precancerous lesions of esophagogastric junctionGUO Huiwen, HE Qibin, LIU Yang, TIE Guangxuan, CHEN Yijia0Department of Gastroenterology, Jiangning Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu 211100, China<b>Objective</b> To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) in the treatment of Siewert type Ⅱ early adenocarcinoma of the esophagogastric junction (AEG) and esophagogastric junction (EGJ) precancerous lesions. <b>Methods</b> The clinical data, endoscopic features, postoperative pathology, intraoperative and postoperative complications and follow-up results of 41 patients with Siewert type Ⅱ early AEG and EGJ precancerous lesions in the Department of Gastroenterology of Nanjing Jiangning Hospital from April 2020 to February 2024 were analyzed retrospectively. <b>Results</b> The success rate of ESD operation was 100%, the complete resection rate of the lesion was 97.6%, the curative resection rate was 73.2%, the coincidence rate of endoscopic and pathological infiltration was 92.7%, and the postoperative pathological upgrade rate was 68.3%. The intraoperative complication rate was 14.6%, with 5 cases showing exposure of the local muscle layer or damage to the superficial muscle layer, and 1 case showing local submucosal fibrosis adhesion with significant bleeding. The postoperative complication rate was 9.8%, with 1 case of splenic rupture, 1 case of delayed postoperative bleeding, and 2 cases of postoperative cardiac stenosis, all of which improved after symptomatic treatment. Follow-up ranged from 2 to 44 months, with a postoperative recurrence rate of 2.3% and an all-cause mortality rate of 7.3%. <b>Conclusion</b> ESD is a minimally invasive, safe and effective endoscopic treatment for early Siewert type Ⅱ AEG and EGJ precancerous lesions, with high complete resection rate and curative resection rate, fewer postoperative complications and no serious adverse event.http://zglcyj.ijournals.cn/zglcyj/ch/reader/create_pdf.aspx?file_no=20250105&year_id=2025&quarter_id=1&falg=1endoscopic submucosal dissectionesophagogastric junctionadenocarcinomaprecancerous lesionpathologycomplicationssafety |
| spellingShingle | GUO Huiwen, HE Qibin, LIU Yang, TIE Guangxuan, CHEN Yijia Clinical effect of endoscopic submucosal dissection in the treatment of Siewert type Ⅱ early adenocarcinoma and precancerous lesions of esophagogastric junction Zhongguo linchuang yanjiu endoscopic submucosal dissection esophagogastric junction adenocarcinoma precancerous lesion pathology complications safety |
| title | Clinical effect of endoscopic submucosal dissection in the treatment of Siewert type Ⅱ early adenocarcinoma and precancerous lesions of esophagogastric junction |
| title_full | Clinical effect of endoscopic submucosal dissection in the treatment of Siewert type Ⅱ early adenocarcinoma and precancerous lesions of esophagogastric junction |
| title_fullStr | Clinical effect of endoscopic submucosal dissection in the treatment of Siewert type Ⅱ early adenocarcinoma and precancerous lesions of esophagogastric junction |
| title_full_unstemmed | Clinical effect of endoscopic submucosal dissection in the treatment of Siewert type Ⅱ early adenocarcinoma and precancerous lesions of esophagogastric junction |
| title_short | Clinical effect of endoscopic submucosal dissection in the treatment of Siewert type Ⅱ early adenocarcinoma and precancerous lesions of esophagogastric junction |
| title_sort | clinical effect of endoscopic submucosal dissection in the treatment of siewert type ii early adenocarcinoma and precancerous lesions of esophagogastric junction |
| topic | endoscopic submucosal dissection esophagogastric junction adenocarcinoma precancerous lesion pathology complications safety |
| url | http://zglcyj.ijournals.cn/zglcyj/ch/reader/create_pdf.aspx?file_no=20250105&year_id=2025&quarter_id=1&falg=1 |
| work_keys_str_mv | AT guohuiwenheqibinliuyangtieguangxuanchenyijia clinicaleffectofendoscopicsubmucosaldissectioninthetreatmentofsiewerttypeiiearlyadenocarcinomaandprecancerouslesionsofesophagogastricjunction |