Endoscopic Submucosal Dissection for Gastroesophageal Reflux Disease-Related Neoplasms

Gastroesophageal reflux disease (GERD) is a widely prevalent disease that severely influences patients' quality of life and is a known risk factor for esophageal adenoma and carcinoma. Endoscopic submucosal dissection (ESD) is a tissue resection technique that involves circumferential en bloc resection of the mucosa that surrounds the tumor followed by dissection of the esophagogastric junction (EGJ) submucosa under the lesion. After mucosal resection, the mucosal healing results in scar formation, which in turn results in shrinkage and remodeling of gastric cardia flap valve, thereby theoretically reducing reflux events. This study investigated the safety and efficacy of ESD for GERD-related neoplasms.

We performed a retrospective analysis of data collected from 96 patients with GERD-related neoplasms treated with ESD between December 2018 and May 2023. Clinical, endoscopic, histologic, and follow-up data were collected.

The overall rates of en bloc resection, complete resection, curative resection, and major complications were 100%, 99.0%, 95.8%, and 8.4%, respectively. During the follow-up period, all patients remained free from local recurrence and metastasis. The proportion of patients who remained alleviation of GERD symptom was 69.6% after 6 months. The proportion of the resected lumen circumference was the factor that affected the alleviation of GERD symptoms.

ESD is safe and effective for GERD-related neoplasms and is efficacious for the high probability of alleviation of GERD symptoms.