Efficacy of Endoscopic Submucosal Dissection for Superficial Esophageal Cancer on the Distal Side of Esophageal Strictures Using a Novel Thin Therapeutic Endoscope

Objectives: Endoscopic submucosal dissection (ESD) for esophageal squamous cell carcinomas (ESCCs) localized on the distal side of strictures requires dilation to pass a conventional endoscope. While an ultra-slim endoscope can pass without dilation, ESD using it remains clinically challenging. Despite its small outer diameter of only 7.9 mm, the EG-840TP features a 3.2-mm working channel, an auxiliary water channel, and 160° downward angulation capability. We evaluated the efficacy and safety of ESD using the EG-840TP for ESCCs localized on the distal side of strictures. Methods: This retrospective study included patients who underwent ESD for ESCCs localized on the distal side of strictures that a conventional endoscope (diameter ≥8.9 mm) could not pass at our institute from December 2015 to November 2024. Patients were categorized into novel thin endoscope (the EG-840TP) and conventional endoscope (treated after stricture dilation) groups. Patients with strictures narrower than 6 mm were excluded. Results: = 0.03). No serious adverse events were observed in either group. Conclusions: ESD using the EG-840TP demonstrated superior efficacy for superficial ESCCs located on the distal side of strictures, offering an alternative to dilation-based approaches.