Pneumomediastinum is a frequent but minor complication during esophageal endoscopic submucosal dissection

Y, Tamiya; Nakahara, K; Kominato, Ken; Serikawa, O; Watanabe, Yutaka; Tateishi, Hikaru; Takedatsu, Hidetoshi; Toyonaga, Atsushi; M, Sata

doi:10.1055/s-0029-1215215

Cited by 58 publications

(36 citation statements)

References 4 publications

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“…The en bloc resection rate is greater than 90% (90 .6%-100%) [24,29,[45][46][47][48][49] . En bloc resection, meaning resection in a single piece, facilitates an accurate histological assessment and reduces the risk of recurrence.…”

Section: Outcomes Of Esophageal Esdmentioning

confidence: 96%

“…En bloc resection, meaning resection in a single piece, facilitates an accurate histological assessment and reduces the risk of recurrence. In fact, the local recurrence rate after esophageal ESD is extremely low (0%-3.1%) [24,29,[45][46][47][48][49] . In contrast, the local recurrence of SCCs after EMR was reported to be as high as 20% because en bloc resection by EMR is difficult and multiple resections are required for large lesions [17] .…”

Section: Outcomes Of Esophageal Esdmentioning

confidence: 98%

“…In a study of 58 patients treated for esophageal neoplasms by ESD, Tamiya et al [47] demonstrated that the incidence of pneumomediastinum detected by computed tomography (CT) was 56.3% (18/32) in the group with muscle exposure, although it was 0% (0/26) in the group without exposure of muscular layer. However, the presence of pneumomediastinum by CT did not imply overt esophageal perforation and did not influence the post- …”

Section: Complicationsmentioning

confidence: 99%

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Endoscopic submucosal dissection for superficial esophageal squamous cell neoplasms

Honda

Akiho

2012

WJGP

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Endoscopic resection is an effective treatment for noninvasive esophageal squamous cell neoplasms (ESCNs). Endoscopic mucosal resection (EMR) has been developed for small localized ESCNs as an alternative to surgical therapy because it shows similar effectiveness and is less invasive than esophagectomy. However, EMR is limited in resection size and therefore piecemeal resection is performed for large lesions, resulting in an imprecise histological evaluation and a high frequency of local recurrence. Endoscopic submucosal dissection (ESD) has been developed in Japan as one of the standard endoscopic resection techniques for ESCNs. ESD enables esophageal lesions, regardless of their size, to be removed en bloc and thus has a lower local recurrence rate than EMR. The development of new devices and the establishment of optimal strategies for esophageal ESD have resulted in fewer complications such as perforation than expected. However, esophageal stricture after ESD may occur when the resected area is larger than three-quarters of the esophageal lumen or particularly when it encompasses the entire circumference; such a stricture requires multiple sessions of endoscopic balloon dilatation.Recently, oral prednisolone has been reported to be useful in preventing post-ESD stricture. In addition, a combination of chemoradiotherapy (CRT) and ESD might be an alternative therapy for submucosal esophageal cancer that has a risk of lymph node metastasis because esophagectomy is extremely invasive; CRT has a higher local recurrence rate than esophagectomy but is less invasive. ESD is likely to play a central role in the treatment of superficial esophageal squamous cell neoplasms in the future.

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Section: Outcomes Of Esophageal Esdmentioning

confidence: 96%

Section: Outcomes Of Esophageal Esdmentioning

confidence: 98%

Section: Complicationsmentioning

confidence: 99%

See 1 more Smart Citation

Endoscopic submucosal dissection for superficial esophageal squamous cell neoplasms

Honda

Akiho

2012

WJGP

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“…Other less frequent complications described in ESD are aspiration pneumonia, transient bacteriemia (112), phlegmonous gastritis (130), gastric ischemia, gastric hematoma (131), transmural pneumatosis, deep vein thrombosis, mediastinal emphysema and tension pneumomediastinum or pneumoperitoneum (132)(133)(134)(135). Peritoneal carcinomatosis is a rare complication and only one case has been published after gastric perforation.…”

Section: Other Complicationsmentioning

confidence: 99%

Endoscopic submucosal dissection: Sociedad Española de Endoscopia Digestiva (SEED) clinical guideline

Fernández‐Esparrach¹,

Calderón

Peña

et al. 2014

Rev. esp. enferm. dig.

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“…The overall incidence of bleeding and perforation with ESD is 11% and 6% respectively [32][33][34]. Due to the widespread acceptance of gastric and oesophageal ESDs, the number of medical facilities that perform colorectal ESDs grew in recent years [35,36].…”

Section: Endoscopic Mucosal Resection (Emr)/endoscopic Submucosal Dismentioning

confidence: 99%

Emergencies after endoscopic procedures

Rolanda

Caetano

Dinis-Ribeiro

2013

Best Practice & Research Clinical Gastroenterology

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Keywords:GI endoscopy adverse events GI emergencies Bleeding Haemorrhage Perforation Infection Embolization Diagnosis and management of severe complications a b s t r a c t Endoscopy adverse events (AEs), or complications, are a rising concern on the quality of endoscopic care, given the technical advances and the crescent complexity of therapeutic procedures, over the entire gastrointestinal and bilio-pancreatic tract. In a small percentage, not established, there can be real emergency conditions, as perforation, severe bleeding, embolization or infection. Distinct variables interfere in its occurrence, although, the awareness of the operator for their potential, early recognition, and local organized facilities for immediate handling, makes all the difference in the subsequent outcome. This review outlines general AEs' frequencies, important predisposing factors and putative prophylactic measures for specific procedures (from conventional endoscopy to endoscopic cholangio-pancreatography and ultrasonography), with comprehensive approaches to the management of emergent bleeding and perforation.

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Pneumomediastinum is a frequent but minor complication during esophageal endoscopic submucosal dissection

Abstract: In esophageal ESD, pneumomediastinum detected by chest CT only does not cause clinically significant complication. Endoscopic muscle exposure during ESD is a significant risk factor for pneumomediastinum, which causes mild inflammation in the early post-ESD phase.

Cited by 58 publications

References 4 publications

Endoscopic submucosal dissection for superficial esophageal squamous cell neoplasms

Endoscopic submucosal dissection for superficial esophageal squamous cell neoplasms

Endoscopic submucosal dissection: Sociedad Española de Endoscopia Digestiva (SEED) clinical guideline

Emergencies after endoscopic procedures

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