Outcomes Of ESD Assisted EMR Versus ESD In Management Of Upper Gastrointestinal Protrusive Lesions

Objective To assess the clinical application of endoscopic submucosal dissection(ESD) assisted endoscopic mucosal resection(EMR) and ESD for upper gastrointestinal protrusive lesions.Methods 31 upper gastrointestinal protrusive lesions resected by one ESD expert From November 2009 to February 2011 were investigated.17(54.8%) were treated by ESD assisted EMR, while 14 lesions were treated by ESD. We compared mean operation time, rate of en bloc resection, immediate and postoperative bleeding, perforation and local recurrence between ESD assisted EMR group and ESD group.Results Mean operation time between ESD assisted EMR group and ESD group(26.4min vs.28.8min) were not significantly different; After the subjects were divided into esophagus group and gastric antrum group, mean operation time of ESD assisted EMR in esophagus group is significantly shorter (14.2 min vs.31.4 min) but longer in gastric group(64.3 min vs.29.7min). The rate of en bloc resection rate (94.1%,100%), immediate bleeding (17.6%,21.4%), postoperative bleeding (0%,0%), perforation (0%,14.3%) and local recurrence (7.1%,10%) were not significantly different between the two groups. Conclusion The efficacy and complications of ESD assisted EMR group and ESD group may be equivalent for resecting upper gastrointestinal protrusive lesions, but ESD assisted EMR may simplify the procedure, shorten the procedure duration when resecting esophagus lensions and be considered to become a nice step to the introduction of ESD.