A149 SAFETY AND EFFICACY OF ENDOSCOPIC SUBMUCOSAL DISSECTION FOR ESOPHAGOGASTRIC NEOPLASMS IN A CANADIAN SETTING

TL;DR

This study shows that endoscopic submucosal dissection is a safe and effective treatment for early esophagogastric tumors in Canada.

Contribution

The paper provides the first detailed Canadian data on ESD outcomes for superficial gastrointestinal neoplasms.

Findings

ESD achieved high technical success (98%) and curative resection rates (80%) for esophagogastric neoplasms.

Adverse events occurred in only 8% of cases, indicating good safety profile.

42% of lesions were upstaged from initial biopsy, highlighting the diagnostic value of ESD.

Abstract

Endoscopic submucosal dissection (ESD) is a technique that has been developed in Japan and is increasingly being adopted by western countries for treatment of superficial gastrointestinal neoplasms.

In this study, we aim to present the safety and efficacy of ESD for esophageal and gastric neoplasms in a Canadian setting, given the limited data regarding the outcomes of ESD in North America

Data of 100 patients with superficial upper GI neoplasms (esophageal and gastric) who underwent ESD between 2016 and 2022 in Kingston Health Sciences Centre, a tertiary hospital in Kingston, Ontario, were retrospectively reviewed. Demographics and lesion characteristics, ESD technique, and outcomes in terms of efficacy and safety were analyzed.

100 patients were included in the study. 67% of the lesions were esophageal. The median diameter was 4.6cm and median area was 11.94cm2. Outcomes were favorable with technical success 98%, en bloc resection 96%, R0 resection 89% and curative resection 80%. Upstage in pathology from index biopsy was seen in 42% of the lesions. Adverse events were infrequently encountered (8%) and included delayed bleeding, aspiration, and pain.

ESD is a safe and effective modality for accurately diagnosing and treating early and superficial esophagogastric neoplasms when performed by trained endoscopists. Further research is required, however, to increase the adoption of this technique across Canada.

Procedural Details

None