Efficacy Analysis Of Endoscopic Submuscosal Dissection For Gastroesophageal Junction Lesions

Object To evaluate the clinical efficacy,feasibility and safety of endoscopic submucosal dissection (ESD) for gastroesophageal junction lesions (GEJ).Method A retrospective study of the clinical data of 20 cases of gastroesophageal junction lesions treated by ESD after gastroscope and endoscopic ultrasonography(EUS) at Department of Gastroenterology from the First Afiliated Hospital of Guangxi Medical University from October 2010 to March 2015 were carried out. The surgical procedure, intraoperative and postoperative complications during follow-up, and clinical efficacy were summarized.Results Of all the 20 patients, the cases were proved to originate from the mucosa layer, muscularis mucosae, submucosal or muscularis propria layer was 9,1,6,4 respectively. All patients could tolerate surgery, All cases were completely resceted en bloc. The average lesion diameter was 2.03±0.71cm (range 1.5～4.5cm),the average operation time was 80.6±46.6min (range 30min～180min). No complications like delayed bleeding, perforation, pneumoperitoneum, mediastinal emphysema and postoperation occurred, and there was no need for the resortation for surgerical treatment. Postoperative pathology were suggestive of 7 hyperplastic polyps,4 leiomyomas,3 moderate to severe dysplasia,2 inflammation,2 tubular adenomatous polyp,1 ulcer,and lleiomyosarcoma.Endoscopic review at 1 to 3 months postoperation in all patients showed no residual disease or relaps.Conclusion ESD with a high en bloc rate,a low local recurrence and residual rate, can resect GEJ lesions completely and provide a complete pathological information,is a safe, effective, minimally invasive and feasible treatment for lesions at GEJ.