Clinical advantage of endoscopic submucosal dissection over endoscopic mucosal resection for early mesopharyngeal and hypopharyngeal cancers
Clinical advantage of endoscopic submucosal dissection over endoscopic mucosal resection for early mesopharyngeal and hypopharyngeal cancers
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DOI：
10.1055/s-0031-1271112
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发表时间：
2011-10-01
期刊：
影响因子：
9.3
通讯作者：
Yahagi, N.
中科院分区：
文献类型：
--
作者：
Iizuka, T.;Kikuchi, D.;Yahagi, N.
背景和研究目的：在以前的系列中，内窥镜粘膜切除术（EMR）已用于治疗早期中咽和下咽癌，以保护患者的生活质量。与EMR相比，内镜粘膜下剥离术（ESD）具有潜在优势。因此，本回顾性研究的目的是评估ESD的效用相比，EMR的早期癌症的中，下咽部。患者和方法：我们研究了56例患者69个病灶进行EMR或ESD之间2001年4月至2008年12月。EMR进行至2007年1月，ESD从2007年2月开始进行。我们评价了整块切除率、R0切除率和治疗相关并发症作为短期结局。局部复发，淋巴结转移，疾病相关的死亡进行了比较，以评估长期outcomes.Results：整块和R0切除率分别为98%和79%，在ESD组和37%和26%的EMR组。EMR组中没有治疗相关并发症病例，但ESD组中有2例患者观察到术后皮下气肿。在EMR组中，1例患者局部复发，1例发生颈淋巴结转移，死于原发cancer.Conclusions：ESD是一种有用的方法治疗早期中咽和下咽癌，可能是上级EMR。
Background and study aims: In previous series, endoscopic mucosal resection (EMR) has been used for the treatment of early-stage mesopharyngeal and hypopharyngeal cancers to preserve patients' quality of life. Endoscopic submucosal dissection (ESD) offers potential advantages in comparison to EMR. So the aim of this retrospective study was to assess the utility of ESD compared with EMR for early-stage cancers of the meso- and hypopharynx.Patients and methods: We studied 56 patients with 69 lesions who underwent either EMR or ESD between April 2001 and December 2008. EMR was performed until January 2007, and ESD was performed from February 2007 onward. We evaluated the en bloc resection rate, R0 resection rate, and treatment-related complications as short-term outcomes. Local recurrence, lymph node metastasis, and disease-related deaths were compared to evaluate long-term outcomes.Results: The en bloc and R0 resection rates were respectively 98% and 79% in the ESD group and 37% and 26% in the EMR group. There were no cases of treatment-related complications in the EMR group, but postoperative subcutaneous emphysema was observed in two patients in the ESD group. In the EMR group, one patient developed a local recurrence and one developed metastasis to the cervical lymph node and died of primary cancer.Conclusions: ESD is a useful method of treatment for early mesopharyngeal and hypopharyngeal cancers and may be superior to EMR.