ArticleJMA journal2026
Comparison of the Efficacy and Safety of General Anesthesia and Sedation Management for Esophageal Endoscopic Submucosal Dissection: A Retrospective Study.
Article in JMA journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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5 authors.
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Abstract
Introduction: General anesthesia (GA) for esophageal endoscopic submucosal dissection (ESD) is expected to reduce surgical complications and shorten surgical time, but definitive conclusions have not yet been reached. We retrospectively compared the efficacy and safety of GA with conventional sedation management. Methods: The study analyzed 224 consecutive cases of esophageal ESD performed at a single institution. The primary outcome was procedure time, and secondary outcomes were duration of endoscopy room stay, incidence of complications (aspiration, perforation, bleeding), and incidence of intraoperative vital sign deterioration (hypotension, bradycardia, hypoxia). Results: The study included 76 patients who underwent GA and 148 patients who underwent sedation (Sed). There was no difference in the median procedure time between the GA group, 67.5 (interquartile range [IQR], 48.8-97.8), and the Sed group, 70 (IQR, 46.0-95.25) minutes (p = 0.993). The median duration of endoscopy room stay was longer in the GA group, 121.5 (102.3-153), than in the Sed group, 90 (69-124) minutes (p = 0.000). There were no significant differences in complications, including aspiration (0/76 vs. 2/148, p = 0.550), perforation (1/76 vs. 3/148, p = 1.000), and bleeding (0/76 vs. 1/148, p = 1.000). Intraoperative vital signs showed a higher incidence of hypotension (70/76 vs. 15/148, p = 0.000) and bradycardia (34/76 vs. 10/148, p = 0.000) in the GA group. Conclusion: There was no difference in procedure time between GA and sedation management for esophageal ESD. Although complications tended to be fewer, hypotension and bradycardia were frequent with GA management. Further investigation is needed to evaluate efficacy and safety.
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