内镜粘膜切除术（EMR）和内镜粘膜下剥离术（ESD）是治疗巴雷特瘤的有效方法。然而，人们对这些技术的复发率知之甚少。我们比较了 EMR 和 ESD 后的长期肿瘤复发率。这项研究纳入了 2019 年 7 月至 2023 年 12 月在加拿大三级转诊中心接受治疗的 Barrett 肿瘤（高度不典型增生/腺癌）患者。结果是首次随访时残留肿瘤、肿瘤完全缓解 (CRN) 以及 CRN 后肿瘤复发。纳入了 157 名患者（87 名 EMR，70 名 ESD）。与EMR相比，ESD组病灶较大（中位2 vs. 3 cm，P<0.05），腺癌较多（85.1% vs. 94.3%，P = 0.07），粘膜下浸润更深（T1a：71.6% vs. 75.8） %；T1b-SM1：25.7% vs. 6.1%；T1b≥SM2：2.7% vs. 18.2%；在 124 名随访患者中（71 名 EMR，53 名 ESD），84.9% 的 ESD 治疗患者进行了根治性切除（即淋巴结转移风险较低的 R0 切除），而 94.4% 的 EMR 治疗患者有深切缘 R0切除低风险病灶。首次随访时，EMR 组和 ESD 组的残余肿瘤（14.1% 比 11.3%）和 CRN（97.2% 比 100%）相似，但 EMR 组 CRN 后肿瘤复发率显着更高（13% 比 100%）。 1.9%，P<0.05)，3年累积复发概率分别为18.3%和4.2%。与ESD相比，EMR后CRN后肿瘤复发率显着高于ESD，表明ESD在预防肿瘤方面可能优于EMR巴雷特食管复发。蒂姆。版权所有。

Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are effective treatments for Barrett's neoplasia. However, little is known about recurrence rates following these techniques. We compared long-term neoplasia recurrence rates following EMR and ESD.This study included patients with Barrett's neoplasia (high grade dysplasia/adenocarcinoma) treated between July 2019 and December 2023 at a tertiary referral center in Canada. Outcomes were residual neoplasia at first follow-up, complete remission of neoplasia (CRN), and neoplasia recurrence following CRN.157 patients were included (87 EMR, 70 ESD). Compared with EMR, the ESD group had larger lesions (median 2 vs. 3 cm, P<0.05), more adenocarcinoma (85.1% vs. 94.3%, P = 0.07), and deeper submucosal invasion (T1a: 71.6% vs. 75.8%; T1b-SM1: 25.7% vs. 6.1%; T1b≥SM2: 2.7% vs. 18.2%; P<0.05). Among 124 patients with follow-up (71 EMR, 53 ESD), 84.9% of ESD-treated patients had curative resections (i.e. R0 resection with low risk for lymph node metastasis), whereas 94.4% of EMR-treated patients had deep margin R0 resection of low risk lesions. At first follow-up, residual neoplasia (14.1% vs. 11.3%) and CRN (97.2% vs. 100%) were similar in the EMR and ESD groups, but neoplasia recurrence following CRN was significantly higher with EMR (13% vs. 1.9%, P<0.05), with cumulative probability of recurrence at 3 years of 18.3% vs. 4.2%, respectively.Neoplasia recurrence following CRN was significantly higher following EMR compared with ESD, suggesting that ESD may be superior to EMR in preventing neoplasia recurrence in Barrett's esophagus.Thieme. All rights reserved.