Efficacy and adverse reactions of endoscopic submucosal dissection and endoscopic submucosal tunnel dissection in early esophageal cancer patients

Table 1 Comparison of demographic characteristics between two groups, n (%)

Parameter	ESD group (n = 156)	ESTD group (n = 101)	t/χ2	P value
Age (years), mean ± SD	65.84 ± 8.85	64.68 ± 9.42	1.001	0.318
Gender			0.059	0.808
Male	120 (76.92)	79 (78.22)
Female	36 (23.08)	22 (21.78)
BMI (kg/m2), mean ± SD	23.51 ± 3.22	24.16 ± 3.54	1.508	0.133
Smoking habit			0.116	0.734
Frequent	94 (60.26)	63 (62.38)
Occasional/non-smoker	62 (39.74)	38 (37.62)
Drinking habit			0.295	0.587
Frequent	78 (50.00)	54 (53.47)
Occasional/non-drinker	78 (50.00)	47 (46.53)
Diabetes			0.857	0.355
Yes	31 (19.87)	25 (24.75)
No	125 (80.13)	76 (75.25)
Hypertension			0.084	0.772
Yes	49 (31.41)	30 (29.70)
No	107 (68.59)	71 (70.30)

ESD: Endoscopic submucosal dissection; ESTD: Endoscopic submucosal tunnel dissection; BMI: Body mass index.

Table 2 Comparison of disease characteristics between two groups, n (%)/mean ± SD

Parameter	ESD group (n = 156)	ESTD group (n = 101)	t/χ2	P value
Histological type			0.345	0.557
ESCC	109 (69.87)	74 (73.27)
BE-EAC	47 (30.13)	27 (26.73)
TNM staging			0.086	0.769
Tis	62 (39.74)	42 (41.58)
T1a	94 (60.26)	59 (58.42)
Tumor invasion depth			0.441	0.802
M1	53 (33.97)	37 (36.63)
M2	62 (39.74)	36 (35.64)
M3	41 (26.28)	28 (27.72)
Maximum tumor diameter (mm)	33.86 ± 10.98	31.92 ± 9.75	1.440	0.151
Tumor location			1.756	0.416
Upper esophagus	16 (10.26)	6 (5.94)
Middle esophagus	58 (37.18)	36 (35.64)
Lower esophagus	82 (52.56)	59 (58.42)
Macroscopic type			0.637	0.888
Elevated type	40 (25.64)	29 (28.71)
Flat type	88 (56.41)	52 (51.49)
Depressed type	23 (14.74)	16 (15.84)
Mixed types	5 (3.21)	4 (3.96)
Circumferential extent			1.139	0.286
< 50%	98 (62.82)	70 (69.31)
50%-75%	58 (37.18)	31 (30.69)

ESD: Endoscopic submucosal dissection; ESTD: Endoscopic submucosal tunnel dissection; ESCC: Esophageal squamous cell carcinoma; BE-EAC: Barrett’s esophagus-associated adenocarcinoma; TNM: Tumor, node, and metastasis.

Table 3 Comparison of the resection effect between two groups, n (%)

Parameter	ESD group (n = 156)	ESTD group (n = 101)	χ2	P value
En bloc resection rate	151 (96.79)	99 (98.02)	0.039	0.844
R0 resection rate	139 (89.10)	97 (96.04)	3.932	0.047

ESD: Endoscopic submucosal dissection; ESTD: Endoscopic submucosal tunnel dissection.

Table 4 Comparison of the recurrence rates between two groups, n (%)

Parameter	ESD group (n = 156)	ESTD group (n = 101)	χ2	P value
Postoperative 1 year	5 (3.21)	2 (1.98)	0.039	0.844
Postoperative 2 years	12 (7.69)	4 (3.96)	1.463	0.227
Postoperative 3 years	20 (12.82)	5 (4.95)	4.324	0.038

ESD: Endoscopic submucosal dissection; ESTD: Endoscopic submucosal tunnel dissection.

Table 5 Comparison of the incidence of procedure-related adverse reactions between two groups, n (%)

Parameter	ESD group (n = 156)	ESTD group (n = 101)	χ2	P value
Adverse reaction incidence rate	27 (17.31)	8 (7.92)	4.592	0.032
Delayed bleeding	8 (5.13)	3 (2.97)
Esophageal stricture	16 (10.26)	8 (7.92)
Infection	2 (1.28)	1 (0.99)
Moderate-to-severe events	11 (7.05)	2 (1.98)	2.312	0.128

ESD: Endoscopic submucosal dissection; ESTD: Endoscopic submucosal tunnel dissection.

Table 6 Comparison of the inflammatory markers between two groups, mean ± SD

Parameter	ESD group (n = 156)	ESTD group (n = 101)	t	P value
IL-8 (pg/mL)
Preoperative	15.32 ± 3.25	15.28 ± 3.43	0.090	0.929
Postoperative 3 days	20.58 ± 4.76	18.94 ± 4.12	2.844	0.005
Postoperative 7 days	15.89 ± 3.82	14.76 ± 3.05	2.629	0.009
TNF-α (pg/mL)
Preoperative	8.45 ± 1.58	8.41 ± 1.62	0.205	0.838
Postoperative 3 days	11.02 ± 2.34	10.15 ± 2.01	3.081	0.002
Postoperative 7 days	8.76 ± 1.95	8.12 ± 1.74	2.691	0.008
hs-CRP (mg/L)
Preoperative	3.44 ± 1.02	3.39 ± 1.08	0.372	0.710
Postoperative 3 days	10.38 ± 3.16	9.31 ± 2.85	2.744	0.006
Postoperative 7 days	6.05 ± 1.83	5.42 ± 1.76	2.726	0.007

ESD: Endoscopic submucosal dissection; ESTD: Endoscopic submucosal tunnel dissection; IL-8: Interleukin-8; TNF-α: Tumor necrosis factor-alpha; hs-CRP: High-sensitivity C-reactive protein.