Abstract
: Esophageal squamous cell neoplasia (ESCN) is the histologic precursor to esophageal squamous cell carcinoma (ESCC), which causes a large burden of disease across the world. Over the past years, on account of the rapid development of endoscopic techniques with highly effectiveness and less invasiveness, the management of ESCN had changed from radical esophagectomy towards endoscopic therapeutics, including endoscopic resection (ER) and ablation techniques. Compared with ER, ablative techniques offer more convenient and safe modality, showing a reasonable efficacy and promising results in eradicating ESCN. Two most widely used ablative therapies for ESCN are radiofrequency ablation and cryoablation. Radiofrequency ablation ablates tissue through heat, while cryoablation coagulates tissue through cold. Recent data show that radiofrequency ablation is highly effective and durable in the removal of early ESCN, and demonstrates a lower rate of stenosis in treating large and extensive ESCN. Meanwhile, cryoablation also demonstrates relatively satisfactory short-term outcome in eradicating ESCN. However, there is still a risk of recurrence and residual lesions for both RFA and cryoablation when treating ESCN. Considering that complete tissue destruction of ablation does not allow histological assessment, staging the neoplasia and deciding which patient may be an ablation candidate before treatment is of great importance, and endoscopic surveillance with Lugol’s chromoendoscopy is also necessary to detect any recurrence and metachronous lesions. Moreover, a combination approach of ER with ablation therapies has promising results in selected patients, and may provide minimally invasive and effective treatment. This review mainly focuses on the role of ablative therapy in practice for squamous cell neoplasia of esophagus.
Published Version
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call