Therapeutic value of endoscopic submucosal dissection for polypus protrusion lesion on esophagogastric junction

Abstract

Objective To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) in the treatment of patients with polypus protrusion lesion on esophagogastric junction(EGJ). Methods A retrospective analysis was made on the data of 111 cases (114 lesions) with EGJ polypus protrusion undergoing ESD. The main observation indicators included ESD resection rate, operation time, complication, and recurrence. Results The diameter of the 114 lesions was 1.0-6.0 cm (mean 2.47±0.80 cm). Among the lesions, 30 had smooth surface, 59 had congestion anabrosis, 11 had nodular rough, 3 were lobulated, 8 had villiform, 1 had slight anabrosis, and 2 had local dent. The postoperative pathology analysis showed 19 lesions were intraepithelial neoplasia and 2 were adenocarcinoma. The rate of neoplasia and cancerization was 18.42% (21/114). The monolithic resection rate of ESD was 100.0% (114/114), complete resection rate was 99.1% (113/114), complete healing resection rate was 97.4% (111/114). The mean operation time was 32.45±7.32 min (17.0-60.0 min). Tardive bleeding after operation occurred in 3 cases, perforation in operation occurred in 1 case, and all the 4 cases were successfully treated by endoscopy. After operation, 2 cases underwent additional surgical procedures. A total of 96 cases were followed-up, with average follow-up time of 28.8 months, and 1 patient (1.04%, 1/96) relapsed. Conclusion The intraepithelial neoplasia and cancerization rate caused by polypus protrusion lesion on EGJ is generally higher than prediction. ESD can monolithic resect lesions with higher complete healing resection rate, fewer complications, and lower recurrence rate. Key words: Polyp; Esophageal polypus; Gastric polyps; Cardiac polypus; Esophagogastric junction; Endoscopic submucosal dissection