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Co-treatment with endoscopic laryngopharyngeal surgery and endoscopic submucosal dissection.

Authors
  • Yamaguchi, Hayato1
  • Sato, Hiroki2
  • Tsukahara, Kiyoaki2
  • Kagawa, Yasuyuki1
  • Okamoto, Isaku2
  • Shimizu, Akira2
  • Nagata, Naoyoshi3
  • Fukuzawa, Masakatsu1
  • Sugimoto, Mitsushige3
  • Kawai, Takashi3
  • Itoi, Takao1
  • 1 Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan. , (Japan)
  • 2 Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, Tokyo, Japan. , (Japan)
  • 3 Endoscopy Center, Tokyo Medical University Hospital, Tokyo, Japan. , (Japan)
Type
Published Article
Journal
Auris, nasus, larynx
Publication Date
Jun 01, 2021
Volume
48
Issue
3
Pages
457–463
Identifiers
DOI: 10.1016/j.anl.2020.10.003
PMID: 33067052
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Endoscopic laryngopharyngeal surgery (ELPS) is an effective and minimally invasive treatment for pharyngeal cancers. However, the disadvantages of ELPS are the interference of instruments in the operative field and the difficulty in approaching certain areas. To overcome these drawbacks, we began to perform combination treatment of ELPS and endoscopic submucosal dissection (ESD). The aim of the present study was to compare the efficacies of treatment with ELPS alone and ELPS combined with ESD. A total of 103 lesions in 73 patients who underwent pharyngeal ELPS for superficial pharyngeal cancer between August 2014 and January 2020 at our hospital were analyzed. Lesions were divided into the ELPS alone group and ELPS combined with ESD group. Lesion characteristics, technical results, adverse events, and long-term outcomes were analyzed. In the ELPS combined with ESD group, procedure speed was shorter than the ELPS alone group (20.2 ± 10.0 mm2/min vs 13.0 ± 6.6 mm2/min, p < 0.001), and R0 resection rate was higher (67.4% vs 45.6%, p = 0.027). There were no significant differences in tumor size, depth of tumor invasion, and adverse events among the 2 groups. These results remained unchanged after propensity score matching. The overall and cause-specific survival rates at 3 years were 96.7% and 100% for the ELPS combined with ESD group and ELPS alone group, respectively. Combination treatment of ESD and ELPS enabled more efficient resection than ELPS alone. Cooperative treatment of pharyngeal cancer patients involving gastroenterologists and head and neck surgeons is effective and beneficial, and results in favorable long-term outcomes. Copyright © 2020. Published by Elsevier B.V.

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