Endoscopic resection of carcinoma in situ of the esophagus accompanied by esophageal varices

Abstract

A case of carcinoma in situ of the esophagus accompanied by esophageal varices was treated by endoscopic mucosal resection using a transparent tube (EMRT) following eradication of the varices via injection sclerotherapy (EIS). Intravariceal injection sclerotherapy was performed for esophageal varices, and after eradication of the varices had been achieved, half of the circumferential esophageal mucosal resection of the cancer lesion was carried out. No serious complication such as perforation or mass bleeding was observed. Cancer-involved mucosa was completely resected and all specimens contributed well to accurate histopathological study, being diagnosed as intraepithelial squamous-cell carcinoma. The artificial ulcer recovered completely, showing no stenotic changes. Our conclusion from this experience is that EIS + EMRT is a valuable and minimally invasive treatment for patients exhibiting this disease, providing an accurate histological diagnosis.

Successful endoscopic submucosal dissection for early gastric cancer adjacent to gastric cardia varix

“…Injection of cyanoacrylate or Nbutyl -2 -cyanoacrylate was difficult because of the small size of the GCV. The effectiveness of ESD combined with intra -variceal EIS using EO to treat early esophageal cancer located close to EVs has also been reported 10) . Because the GCV leads directly to EVs, intra -variceal EIS using EO to treat EVs induces vessel thrombosis in the GCV concomitantly with vessel thrombosis in the EVs without the formation of fibroses.…”

Endoscopic Submucosal Dissection Combined With Endoscopic Injection Sclerotherapy for Early Gastric Cancer on Gastric Fundal Varices

“…3 Controlling hemodynamics of GFVs is essential before further invasive treatment by endoscopic procedure, but currently there is no guideline for EGC on GFVs. Although effectiveness of EMR combined with EIS or EVL for early esophageal cancers on esophageal varices were demonstrated, 1,7 previous studies revealed that control of GFVs was more challenging than that of GCVs associated with esophageal varices, as GFVs were quite different from GCVs in angioarchitecture. 8,9 Previous studies represented that most of GFVs were developed to large caliber varices in submucosa as a part of splenogastrorenal shunt running through the gastric wall, 9 but GFVs in this case had no communication with other obvious vessels of portosystemic blood shunt.…”

Management of high grade dysplasia in Barrett's oesophagus with underlying oesophageal varices: A retrospective study

“…Endomucosal resection can be effectively performed for the treatment of small, early oesophageal squamous cell carcinoma [24], usually for patients unwilling or unsuitable to undergo surgery. Endomucosal resection has been successful for early oesophageal neoplasia in cirrhotic patients with oesophageal varices, but only after complete oesophageal varices eradication [25][26][27][28]. Sawaguchi et al described ESD of nine oesophageal squamous cell carcinomas with oesophageal varices, preceded by EBL two cases when the neoplasia was on the oesophageal varices [29].…”