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Tunnelling and clip-with-line techniques for successful long circumferential esophageal ESD (Menção Honrosa - Vídeo)
Daniela Falcão; Joana Alves-Silva; Sara Archer; Isabel Pedroto; Ricardo Marcos-Pinto; Ricardo Küttner-Magalhães
Centro Hospitalar Universitário do Porto
A 67-year-old man presented with a circumferential esophageal squamous cell carcinoma, Paris 0-IIa, type V3 intrapapillary-capillary-loop classification, from 37 to 43 cm from the incisors and multiple proximal minor Paris 0-IIb+0-IIc lesions.
Circumferential endoscopic submucosal dissection (ESD) was performed beginning with proximal and distal circumferential mucosal incisions, followed by two contralateral submucosal-tunnels, leaving two longitudinal lateral bridges. Then, the additional use of the clip-with-line technique allowed constant traction of the specimen enabling dissection of the remaining lateral bridges. A full circumferential 15 cm long specimen was retrieved.
We demonstrated that combining tunnelling and clip-with-line techniques enables successful circumferential oesophageal ESD.
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