TY - JOUR
T1 - Laparoscopic transgastric esophageal mucosal resection
T2 - 4-year minimum follow-up
AU - Frantzides, Constantine T.
AU - Carlson, Mark A.
AU - Keshavarzian, Ali
AU - Roberts, Jacob E.
PY - 2010/8
Y1 - 2010/8
N2 - Background: The management of high-grade esophageal dysplasia has included surveillance, endoscopic ablative techniques, and esophagectomy. Herein we describe an alternative treatment, laparoscopic transgastric esophageal mucosal resection. Methods: Laparoscopic transgastric esophageal mucosal resection was accomplished through an anterior gastrotomy. The mucosa was stripped from the Z-line to the proximal extent of the abnormal epithelium. The gastrotomy then was closed with a linear stapler, and a Nissen fundoplication was performed. Results: Six patients with high-grade dysplasia of the distal esophagus underwent mucosal resection. After 4 to 7 years of endoscopic surveillance, all patients have regenerated squamous epithelium. One patient developed nondysplastic Barrett's esophagus after 2 years and was treated medically. Two strictures were treated successfully with dilatation. Conclusions: Laparoscopic transgastric esophageal mucosal resection was a reasonable treatment for high-grade dysplasia in this small sample of patients. This technique is a potential alternative treatment for high-grade dysplasia of the esophagus.
AB - Background: The management of high-grade esophageal dysplasia has included surveillance, endoscopic ablative techniques, and esophagectomy. Herein we describe an alternative treatment, laparoscopic transgastric esophageal mucosal resection. Methods: Laparoscopic transgastric esophageal mucosal resection was accomplished through an anterior gastrotomy. The mucosa was stripped from the Z-line to the proximal extent of the abnormal epithelium. The gastrotomy then was closed with a linear stapler, and a Nissen fundoplication was performed. Results: Six patients with high-grade dysplasia of the distal esophagus underwent mucosal resection. After 4 to 7 years of endoscopic surveillance, all patients have regenerated squamous epithelium. One patient developed nondysplastic Barrett's esophagus after 2 years and was treated medically. Two strictures were treated successfully with dilatation. Conclusions: Laparoscopic transgastric esophageal mucosal resection was a reasonable treatment for high-grade dysplasia in this small sample of patients. This technique is a potential alternative treatment for high-grade dysplasia of the esophagus.
KW - Barrett's esophagus
KW - Esophageal adenocarcinoma
KW - Gastroesophageal reflux disease
KW - High-grade esophageal dysplasia
KW - Minimally invasive surgery
KW - Mucosal ablation
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U2 - 10.1016/j.amjsurg.2009.10.011
DO - 10.1016/j.amjsurg.2009.10.011
M3 - Article
C2 - 20188346
AN - SCOPUS:77955901781
VL - 200
SP - 305
EP - 307
JO - American Journal of Surgery
JF - American Journal of Surgery
SN - 0002-9610
IS - 2
ER -