TUNNELLING AND CLIP-WITH-LINE TECHNIQUES FOR SUCCESSFUL LONG CIRCUMFERENTIAL ESOPHAGEAL ESD

A 67-year-old man was referred due to a circumferential 6cm, Paris 0-IIa, type V3 intrapapillary-capillary-loop classification lesion,from 37 to 43cm from the incisors, with biopsies revealing squamous cell carcinoma. Multiple minor Paris 0-IIb+0-IIc lesions were also observed proximally. Circumferential endoscopic submucosal dissection (ESD) was scheduled. Proximal and distal circumferential mucosal incisions were made. Two contralateral submucosal tunnels were accomplished, leaving two longitudinal lateral bridges.The additional use of clip-with-line technique allowed constant traction of the specimen enabling dissection of the remaining lateral bridges. A 15cm long specimen was retrieved.We demonstrated that combining tunnelling and clip-with-line techniques enables successful circumferential esophageal ESD.

Publication History

Article published online:
14 April 2022