Feasibility of endoscopic submucosal dissection of benign esophageal tumors in patients with hepatitis B virus-related cirrhosis

Abstract

Abstract: Objective To analyze the feasibility of endoscopic submucosal dissection (ESD) of benign esophageal tumors in patients with hepatitis B virus-related cirrhosis. Methods The hospital medical record management system between January 2010 and June 2020 was reviewed. One hundred and seventy-four patients of benign esophageal tumors treated with ESD were included, with an average age of (53.2±10.5). The numbers of male and female were 92 and 82, respectively. Thirty-four patients with hepatitis B virus-related cirrhosis were selected as the cirrhosis group, and 140 patients without hepatitis B virus-related cirrhosis were selected as the non-cirrhosis group. The differences of measurement data were analyzed through the t-test or Kruskal-Wallis H test, and the differences of enumeration data were analyzed through the chi-square test. Results The Child-Pugh score of cirrhosis group and non-cirrhosis group were 7 (5, 12) and 0 (0, 0), respectively, the difference was statistically significant (P<0.05). The platelet count of cirrhosis group [152 (110, 318) × 10⁹/L] was significantly lower than that of non-cirrhosis group [245 (142, 330) ×10⁹/L, P<0.05], while international normalized ratio (INR) of cirrhosis group [1.2 (1.0, 1.8)] was significantly higher than that of non-cirrhosis group [1.0 (0.9, 1.3), P<0.05]. In addition, there was no significant difference in age, sex, white blood cell (WBC), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin and albumin between the two groups. There was no significant difference in the diameter of esophageal benign tumor, esophageal leiomyoma, tumor location, ESD operation time and the number of complete tumor resection between the two groups. But there were 6 (17.6%) and 5 (3.6%) cases had postoperative bleeding in liver cirrhosis group and non-cirrhosis group, respectively, and the difference was statistically significant (P<0.05). Five cases of postoperative bleeding in cirrhosis group were combined with esophageal varices. Esophageal perforation or death related to ESD was not occurred in both groups. Conclusion ESD is safe and effective in the treatment of benign esophageal tumors in patients with hepatitis B virus-related cirrhosis, especially in patients without severe liver cirrhosis complications.

Key words: Endoscopic submucosal dissection, Hepatitis B virus-related cirrhosis, Benign esophageal tumors

CHEN Yan-lei, CAI Yong-guo. Feasibility of endoscopic submucosal dissection of benign esophageal tumors in patients with hepatitis B virus-related cirrhosis[J]. Chinese Hepatolgy, 2021, 26(9): 984-986.

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