New endoscopic treatment for superficial carcinoma of borderline lesions between the cervical esophagus and hypopharynx.

Abstract

107 Background: Early diagnosis and early treatment are the best ways to improve cancer patient prognoses. We developed ELPS (endoscopic laryngo-pharyngeal surgery) as an endoscopic treatment for superficial pharyngeal carcinoma. ELPS is transoral endoscopic surgery for laryngeal cancer. After lifting the larynx using the laryngoscope, the endoscopist inserts endoscope and the operator inserts forceps and electric device transorally, and resects superficial phayngeal carcinoma. However, ELPS has not been applied for cervical esophagus carcinoma because of the narrow working space. We developed a hybrid endoscopic surgery (ESD+ELPS) for borderline lesions between the cervical esophagus and hypopharynx. The purpose of this study was to examine the usefulness and effectiveness of endoscopic treatment for superficial carcinoma of the hypopharynx and cervical esophagus. Methods: Hybrid endoscopic surgery (ESD and ELPS) was performed on 8 lesions, which involved both the hypopharynx and cervical esophagus. Results: Six of eight patients had esophageal cancer treatments in their past histories, two for ESD, two for esophagectomy and two for chemoradiation. All lesions were completely resected. The complications of this procedure were laryngeal edema for three patients, which required overnight intubation, and stenosis of cervical esophagus for two patients, which required endoscopic dilation more than 10 times. There were no long term complications in all patients. Conclusions: The results indicated the usefulness and effectiveness of hybrid endoscopic treatment (ELPS+ESD) for superficial carcinoma of borderline lesion between the cervical esophagus and hypopharynx.