ArticleSurgical endoscopy2019
Predictors of technical difficulty during endoscopic submucosal dissection of superficial esophageal cancer.
Article in Surgical endoscopy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 36 citations in OpenAlex.
- Efficacy of lidocaine injection method for esophageal endoscopic submucosal dissection: single-center, double-blind, randomized controlled trial.Surgical endoscopy · 2023Trial
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- Comparison of the Efficacy and Safety of General Anesthesia and Sedation Management for Esophageal Endoscopic Submucosal Dissection: A Retrospective Study.JMA journal · 2026Article
- Endoscopic full-thickness resection of upper gastrointestinal stromal tumors: a retrospective study from a large tertiary hospital in China.Surgical endoscopy · 2026Article
- A prediction score model of difficult endoscopic submucosal dissection for early esophageal cancer and precancerous lesions.Annals of medicine · 2025Article
- Characteristics of Esophageal Squamous Cell Carcinomas Based on Circumferential Localization.JGH open : an open access journal of gastroenterology and hepatology · 2024Article
- Predictors of technical difficulty for trainees in esophageal endoscopic submucosal dissection.Esophagus : official journal of the Japan Esophageal Society · 2024Article
- Endoscopic submucosal dissection for superficial ultra-low rectal tumors: outcomes and predictive factors for procedure difficulty.American journal of cancer research · 2024Article
- Predictive Factors for the Outcome of Unsupervised Endoscopic Submucosal Dissection During the Initial Learning Curve with Prevalence-Based Indication.Digestive diseases and sciences · 2023Article
- Development and validation of a preoperative difficulty scoring system for endoscopic resection of gastric gastrointestinal stromal tumor: a multi-center study.Surgical endoscopy · 2023Article
- Safety and efficacy of endoscopic submucosal dissection for superficial esophageal cancer with esophageal varices.Esophagus : official journal of the Japan Esophageal Society · 2023Observational
- The relationship between the esophageal endoscopic submucosal dissection technical difficulty and its intraoperative process.Esophagus : official journal of the Japan Esophageal Society · 2023Article
- Automated machine learning to predict the difficulty for endoscopic resection of gastric gastrointestinal stromal tumor.Frontiers in oncology · 2023Article
- Intelligent Identification of Early Esophageal Cancer by Band-Selective Hyperspectral Imaging.Cancers · 2022Article
- Gel immersion endoscopic submucosal dissection: clinical experience with 13 cases of superficial esophageal cancer.Endoscopy international open · 2022Article
- Associated risk factor analysis and the prognostic impact of positive resection margins after endoscopic resection in early esophageal squamous cell carcinoma.Experimental and therapeutic medicine · 2022Article
- Propensity-score matched analysis to evaluate efficacy of endoscopic submucosal dissection for superficial esophageal cancer in gastrectomized patients.Scientific reports · 2022Article
- Predictive factors for difficult endoscopic submucosal dissection for esophageal neoplasia including failure of en bloc resection or perforation.Surgical endoscopy · 2021Article
- Predictors for Submucosal Fibrosis in Patients With Superficial Squamous Esophageal Neoplasia Undergoing Endoscopic Submucosal Dissection.Clinical and translational gastroenterology · 2020Article
- Comparison of the therapeutic effects of endoscopic submucosal dissection and minimally invasive esophagectomy for T1 stage esophageal carcinoma.Thoracic cancer · 2019Article
Corrections and comments
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Authors and funding
14 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEndoscopic submucosal dissection (ESD) is the standard treatment for superficial esophageal cancer (SEC); however, it is sometimes technically difficult. Our aim was to identify the predictors of technical difficulty during ESD for SEC.
methodsWe reviewed the records of patients who underwent ESD for superficial esophageal squamous cell carcinomas at a tertiary cancer center between April 2008 and March 2016. Patients undergoing ESD after esophagectomy or for residual/recurrent lesions were excluded. Preoperative factors such as tumor subsite, localization, preoperative size, macroscopic type, endoscopic depth of invasion, and treatment for synchronous multiple SECs or previous history of radiation therapy were analyzed. Logistic regression analysis was performed to identify the predictors of technical difficulty, defined as (1) long procedure time (≥ 120 min), (2) adverse events (perforation, pneumomediastinum), or (3) incomplete resection (piecemeal resection, positive or indeterminate vertical margin).
resultsA total of 679 lesions in 511 patients were analyzed. Difficultly was experienced in 60 cases. The procedure time was > 120 min in 43 (6.3%) patients, adverse events occurred in 16 (2.8%), and incomplete resection occurred in 17 (2.5%). Multivariate logistic regression revealed that tumors in the left esophageal wall (OR 2.15; 95% CI 1.17-3.91; p = 0.014) and those encompassing ≥ 1/2 its circumference (OR 5.06; 95% CI 2.40-11.34; p < 0.001) were independently associated with difficulty.
conclusionsTumors in the left esophageal wall and tumors measuring > 1/2 of the esophageal circumference are predictors of difficult esophageal ESD. These results may contribute to better patient selection according to each endoscopist's skill.
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