Su1495 ESD Optimization in the Esophagus Using the Tunnel Method : Comparative Study With the Standard ESD Technique

Abstract

Endoscopic Submucosal Dissection (ESD) allows “en bloc” R0 resection for esophageal neoplastic lesions larger than 15 mm. However, it is considered as a high risk and time consuming method. Tunnel technique consists first to perform an incision at the lower and upper edges of the lesion, and then to create a “Tunnel” in the submucosal space between mucosa and muscle in order to join both incisions, and to finish by lateral incisions. The main advantage of the “Tunnel” in comparison to standard ESD is to more easily separate mucosa from muscular layer by avoiding rapid disappearance of the liquid lifting and by stretching the mucosa.