Endoscopic mucosal resection versus esophagectomy for intramucosal adenocarcinoma in the setting of barrett’s esophagus
| العنوان: | Endoscopic mucosal resection versus esophagectomy for intramucosal adenocarcinoma in the setting of barrett’s esophagus |
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| المؤلفون: | James Ellsmere, Drew Bethune, Jeffrey David Hawel, Chao Li, Harry Henteleff, Denise Tami Yamashita |
| المصدر: | Surgical Endoscopy. 31:4211-4216 |
| بيانات النشر: | Springer Science and Business Media LLC, 2017. |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | Male, medicine.medical_specialty, Endoscopic Mucosal Resection, Esophageal Neoplasms, medicine.medical_treatment, Endoscopic mucosal resection, Adenocarcinoma, Anastomosis, Gastroenterology, Barrett Esophagus, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, Esophagus, Aged, Retrospective Studies, business.industry, Retrospective cohort study, Middle Aged, medicine.disease, Esophagectomy, Exact test, Treatment Outcome, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Barrett's esophagus, Disease Progression, Female, 030211 gastroenterology & hepatology, Surgery, Neoplasm Recurrence, Local, business, Follow-Up Studies, Abdominal surgery |
| الوصف: | Esophagectomy has been the standard of care for patients with intramucosal adenocarcinoma (IMC) in the setting of Barrett’s esophagus. It is, however, associated with significant post-operative morbidity and mortality. Endoscopic mucosal resection (EMR) offers a minimally invasive approach with lesser morbidity. This study investigates the transition from esophagectomy to EMR for IMC with respect to eradication rates, post-operative morbidity, and long-term survival. Patients diagnosed with IMC from 2005 to 2013 were identified retrospectively. Beginning in 2009, preferred initial therapy for IMC transitioned from esophagectomy to EMR. Esophagectomy was performed either through a transthoracic or transhiatal technique. EMR was repeated until resolution of IMC on pathology or progression of disease. Continuous data are expressed as mean (SD) and analyzed using Student’s t test. Categorical data are presented as number (%) and analyzed using Fisher’s exact test. We identified 23 patients; 12 patients underwent esophagectomy and 11 patients underwent EMR as initial therapy. Patients were similar with respects to age, gender, and comorbidity index. Most tumors arose from short segment (vs long segment) Barrett’s (esophagectomy: 9 (75%) vs. EMR: 10 (91%), p = 0.59) and one patient in each group had superficial invasion into the submucosa (T1sm1), the remainder having mucosal disease. Esophagectomy was associated with 7 (58%) minor complications and 2 (17%) major complications (respiratory failure, anastomotic leak), whereas there were no complications related to EMR (p |
| تدمد: | 1432-2218 0930-2794 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a060d32b4110b0b0b40ac19f8dab70c1Test https://doi.org/10.1007/s00464-017-5479-zTest |
| حقوق: | CLOSED |
| رقم الانضمام: | edsair.doi.dedup.....a060d32b4110b0b0b40ac19f8dab70c1 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14322218 09302794 |
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