The feasibility of endoscopic submucosal dissection for superficial esophageal cancer in patients with cirrhosis (with video)

Endoscopic Submucosal Dissection of Superficial Esophageal Neoplasms Is Feasible and Not Riskier for Patients with Liver Cirrhosis

“…For elective invasive procedures, only severe thrombocytopenia (<50 × 10 3 /mm 3 ) is used as a cut-off value in terms of contraindications [21]. Our results confirmed that esophageal ESD can be safely performed on cirrhotic patients without severe thrombocytopenia [12]. …”

“…However, because of concerns about increased complications, cirrhotic patients with SENs underwent ESD uncommonly and there has previously been only one case series published in the literature [12]. Therefore, we believe that prospective multicenter studies are required to enroll a larger number of patients.…”

“…Based on these factors, cirrhotic patients with SENs may have been excluded from ESD treatment by some endoscopists. To our knowledge, the use of esophageal ESD to treat cirrhotic patients has only been reported in one case series [12]. The feasibility of esophageal ESD in cirrhotic patients remains unclear, and how the results obtained treating cirrhotic patients compare with those for non-cirrhotic patients remains unknown.…”

A Pilot Experience of Endoscopic Submucosal Dissection of Barrett’s Dysplasia Despite Esophageal Varices and Decompensated Cirrhosis

“…As BE is rarely encountered in Asia, the published Asian esophageal ESD literature addresses mainly squamous cell carcinomas. Two case series of ESD in patients with esophageal squamous cell carcinomas have been reported, by Sawaguchi et al in Japan (7 patients) and Tsou et al in Taiwan (8 patients, 11 cases). All patients in these small series had compensated cirrhosis with platelet counts >50 k/μL.…”

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

“…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]. A small series of successful endomucosal resection for BE with high grade dysplasia in the context of portal hypertension has been previously published, but this series was small and had limited follow up [6].…”