ASGE-JGES Endoscopic Submucosal Dissection ESD (On-demand)

Video Transcription

Video Summary

The discussion centers on treating circumferential squamous cell esophageal cancer, T1A, larger than 5 cm. Japanese guidelines recommend phagectomy due to lymph node metastasis risk, whereas in the U.S., endoscopic submucosal dissection (ESD) is often performed, especially for high surgical risk patients followed by radiation. Multidisciplinary tumor board discussions are emphasized to tailor treatment considering patient comorbidities and preferences. Preventing post-ESD strictures involves steroid injections (e.g., triamcinolone) or topical treatments like fluticasone to reduce inflammation. Steroid use varies by region, with some reluctance in the U.S. due to risks. Patient adherence to dilation schedules is crucial if strictures develop.

Keywords

circumferential squamous cell esophageal cancer

phagectomy

endoscopic submucosal dissection

post-ESD stricture prevention

multidisciplinary tumor board