Endoscopy 2009; 41(2): 113-117
DOI: 10.1055/s-0028-1119453
Original article

© Georg Thieme Verlag KG Stuttgart · New York

Endoscopic submucosal dissection for treatment of mesopharyngeal and hypopharyngeal carcinomas

T.  Iizuka1 , D.  Kikuchi1 , S.  Hoteya1 , N.  Yahagi1 , H.  Takeda2
  • 1Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan
  • 2Department of Otorhinolaryngology, Toranomon Hospital, Tokyo, Japan
Further Information

Publication History

submitted 16 June 2008

accepted after revision 5 November 2008

Publication Date:
12 February 2009 (online)

Background and study aims: Application of the endoscopic submucosal dissection (ESD) technique, as well as elevation of the larynx in cooperation with an otolaryngologist, under general anesthesia has enabled en-block resection of early mesopharyngeal and hypopharyngeal carcinomas. The aim of this study was to retrospectively evaluate the safety of ESD and the efficacy of the elevation of the larynx for treatment of early mesopharyngeal and hypopharyngeal carcinomas.

Patients and methods: The study included 16 lesions in 13 patients who underwent ESD. To provide a sufficient working space, the larynx was elevated under direct laryngoscopy, and a tube was inserted and fixed onto the laryngeal side using the slot on the back of the laryngoscope.

Results: The median maximum diameter of the lesions was 12.5 mm (range 2 – 37 mm). The en-block resection rate was 93.8 %. Lateral surgical margins in two patients were difficult to evaluate for technical reasons. The tube could not be removed from four patients on the day of the procedure due to laryngeal edema caused by the local injection. No serious complications were observed. Oral food intake was possible after a mean of 3.3 postoperative days.

Conclusions: With adequate intraoperative and postoperative management, ESD with elevation of the larynx may be very efficient and safe for endoscopic treatment of pharyngeal lesions.

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T. IizukaMD 

2-2-2 Toranomon
Minato-ku
Tokyo
Japan 105-8470

Fax: +81-3-35827068

Email: t-iizuka@toranomon.gr.jp