{
  "abstract": "Introduction Endoscopic submucosal dissection (ESD) has been recommended as the treatment of choice for early oesophageal neoplastic lesions with fewer adverse events and comparable overall & disease free 5-year survival to surgery. 1 ESD offers a key advantage of higher en-bloc (98%), R0 and curative resection rates (78%) compared to endoscopic mucosal resection.2 However, in a recent survey, less than 50% and less than 30% of UK NHS trusts provide ESD and upper GI ESD respectively.3Methods In this retrospective study, we examined patient demographics and technical outcomes for ESD performed for early oesophageal neoplastic lesions in a tertiary referral centre in the UK. This included en-bloc rate, R0 resection rate, length of stay, immediate and delayed complication rates.Results Since its Introduction in 2017 at University Hospitals of North Midlands,185 patients (126 males, 59 females) had ESD for early oesophageal neoplastic lesions, with median age 72 years (Range 34 – 93 years). This included 69% adenocarcinomas (n=128), 5% Barrett’s related high grade dysplasia (n=10), 23% squamous neoplasia (n=43) including invasive Squamous cell carcinoma/ SCC in situ and 4 miscellaneous lesions (granular cell tumour n=1, leiomyoma n=1, hyperplastic polyps n=2). Median procedure time was 120 ± 49.3 minutes. En-bloc resection rate was 94.6% of cases (n=175) and R0 resection rate 74.6% (n=138). Median length of stay was 1 day with range 0 (same day discharge) – 17 days. Immediate complications included 5 cases of intra-procedural perforation (2.7%), all of which were managed endoccopically with no substantial post-procedure sequalae. Delayed complications included transient pleural effusions n=2, delayed bleeding n=3. 29.7% (n=55) developed oesophageal stricture which required dilatation +/- stenting after circumferential or semi-circumferential resections.Conclusion ESD is an effective and safe treatment option for early oesophageal neoplasia with short length of stay and low risk of immediate/ delayed adverse events. En bloc resection by ESD can be curative and provides accurate histology to stage the disease to guide further treatment.References Pimentel-Nunes P, Libânio D, Bastiaansen BAJ, et al., Endoscopic submucosal dissection for superficial gastrointestinal lesions: European Society of Gastrointestinal Endoscopy (ESGE) Guideline - Update 2022. Endoscopy. 2022;54(6):591–622.Radadiya D, Desai M, Patel H, et al. Endoscopic submucosal dissection and endoscopic mucosal resection for Barrett’s-associated neoplasia: a systematic review and meta-analysis of the published literature. Endoscopy. 2024;56(12):940–954.Archer T, Raheja A, Goodoory V, et al. P174 ESD in the UK; limited provision and barriers to training. Gut 2025;74:A192–A193.Abstract P370 Figure 1",
  "authors": [
    {
      "affiliations": [
        "University Hospitals of North Midlands, Stoke on Trent, United Kingdom"
      ],
      "name": "Walaa Shaheen"
    },
    {
      "affiliations": [
        "University Hospitals of North Midlands, Stoke on Trent, United Kingdom"
      ],
      "name": "George Bouras"
    },
    {
      "affiliations": [
        "University Hospitals of North Midlands, Stoke on Trent, United Kingdom"
      ],
      "name": "Vamshi Jagadesham"
    },
    {
      "affiliations": [
        "University Hospitals of North Midlands, Stoke on Trent, United Kingdom"
      ],
      "name": "Sarveson Rajkumar"
    }
  ],
  "title": "P370 ESD for early oesophageal neoplasia in a tertiary referral UK centre; Single centre study on Efficacy and Safety",
  "uid": "61f3ce33-4374-5f93-9ffd-d1584b72a990"
}