Published online Aug 7, 2013. doi: 10.3748/wjg.v19.i29.4781
Revised: June 22, 2013
Accepted: June 28, 2013
Published online: August 7, 2013
AIM: To assess esophageal motility after esophageal endoscopic submucosal dissection (ESD).
METHODS: Twelve patients (6 men and 6 women) aged 53-64 years (mean age, 58 years) who underwent regular examination 3-12 mo after esophageal ESD for neoplasms of the esophageal body were included in this study. The ESD procedure was performed under deep sedation using a combination of propofol and fentanyl, and involved a submucosal injection to lift the lesion and use of a dual-knife and an insulated-tip knife to create a circumferential incision around the lesion extending into the submucosa. Esophageal motility was examined using a high-resolution manometry system. Dysphagia was graded using a five-point scale according to the Mellow and Pinkas scoring system. Patient symptoms and the results of esophageal manometry were then analyzed.
RESULTS: Of the 12 patients enrolled, 1 patient had grade 2 dysphagia, 1 patient had grade 1 dysphagia, and 3 patients complained of sporadic dysphagia. Ineffective esophageal motility was observed in 5 of 6 patients with above semi-circumference of resection extension. Of these 5 patients, 1 patient complained of grade 2 dysphagia (with esophageal stricture), one patient complained of grade 1 dysphagia, and 3 patients complained of sporadic dysphagia. Normal esophageal body manometry was observed in all 6 patients with below semi-circumference of resection extension. The 6 patients with normal esophageal motility did not complain of dysphagia.
CONCLUSION: Extensive esophageal ESD may cause esophageal dysmotility in some patients, and might also have an influence on dysphagia although without esophageal stricture.
Core tip: Endoscopic submucosal dissection (ESD) is widely used to treat esophageal epithelial neoplasms. ESD has the advantage over esophagectomy of being less invasive and having lower postoperative morbidity. ESD also has the advantage over endoscopic mucosal resection of enabling the removal of larger epithelial neoplasms in an en bloc manner for complete resection. It is not known whether esophageal ESD affects esophageal motility. Therefore, the present study aimed to evaluate the effects of ESD on esophageal motility.