Efficiency and safety of endoscopic therapy for early esophageal cancer and precancerous lesions with length more than 5 cm

Abstract

Objective To compare the effectiveness and safety of endoscopic submucosal dissection (ESD) with endoscopic piecemeal mucosal resection (EPMR) for early esophageal cancer and precancerous lesions with length more than 5 cm. Methods A retrospective analysis was performed on data of 85 patients diagnosed as early esophageal cancer and precancerous lesions with length more than 5 cm in Fujian Medical Association of Early Esophageal Carcinoma from January 2012 to July 2017. The patients were divided into ESD group (52 cases) and EPMR group (33 cases), and the effectiveness and safety between the two groups were compared. Results There was no significant difference on the complete resection rate between the two groups[86.5% (45/52) VS 87.9% (29/33), P>0.05]. The operative time (58.53±30.50 min VS 32.06±9.12 min), postoperative fasting time (4.18±1.30 d VS 3.67±0.96 d), postoperative hospital-stay time (7.45±2.44 d VS 6.54±1.73 d), and postoperative antibiotics using time (3.48±2.33 d VS 1.96±2.20 d) in ESD group were higher than those in EPMR group (all P 0.05). But the postoperative stricture rate of ESD group was higher than that of EPMR group[23.1% (12/52) VS 6.1% (2/33), P 0.05). Conclusion ESD and EPMR have equivalent efficacy and safety on the treatment of early esophageal cancer and precancerous lesion. EPMR has a shorter operative time, lower rate of post-operative stricture, and is easier to master. Key words: Esophageal neoplasms; Endoscopic piecemeal mucosal resection; Endoscopic submucosal dissection; Efficiency; Safety