食管内镜粘膜下剥离术 (ESD) 期间的穿孔通常是由电损伤引起的。然而，在某些情况下，由于肠肌肉组织节段性缺失（SAIM）而发生穿孔，而没有医源性肌肉损伤。我们调查了食管 ESD 期间 SAIM 的发生率和临床病程。我们对 2013 年至 2019 年在日本 10 个中心进行的食管 ESD 进行了回顾性评价。1708 名患者中，有 5 名（0.29%）因食管癌接受了 ESD 并患有 SAIM。中位肌肉缺损尺寸为 20 毫米。所有病灶均被切除，未停药。切除后，三名患者使用 Endoloop 进行闭合。 4 名患者患有纵隔气肿。所有患者均接受保守治疗。SAIM 是一种非常罕见的疾病，通常仅在 ESD 期间诊断。进行食管 ESD 的医生应该了解 SAIM。当检测到 SAIM 时，应修改 ESD 技术以防止全层穿孔。版权所有 © 2023 美国胃肠内窥镜协会。由爱思唯尔公司出版。保留所有权利。

Perforation during esophageal endoscopic submucosal dissection (ESD) typically results from electrical damage. However, there are cases in which perforation occurs due to segmental absence of intestinal musculature (SAIM) without iatrogenic muscular injury. We investigated the occurrence rate and clinical course of SAIM during esophageal ESD.We conducted a retrospective review of esophageal ESDs performed between 2013 and 2019 in 10 centers in Japan.Five of 1708 patients (0.29%) received ESD for esophageal cancer and had SAIM. The median muscular defect size was 20 mm. All lesions were resected without discontinuation. After resection, three patients were closed with Endoloop. Four patients had mediastinal emphysema. All patients were managed conservatively.SAIM is a very rare condition, which is usually only diagnosed during ESD. Physicians performing esophageal ESD should be aware about SAIM. When SAIM is detected, the ESD technique should be modified to prevent full-thickness perforation.Copyright © 2023 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.