Abstract:Objective To compare the effects of endoscopic submucosal dissection (ESD) and endoscopic piecemeal mucosal resection (EPMR) in the treatment of esophageal mucosal lesions larger than 15 mm in diameter. Methods A retrospective analysis was performed on the clinical data of 200 patients with esophageal mucosal lesions (more than 15 mm in diameter) admitted to hospital from January 2012 to October 2017.The patients were divided into ESD group(receiving ESD operation) and EPMR group (receiving EPMR operation,n=100,each).The clinical outcomes,the complications and the recurrence during one-year follow-up were observed and compared between two groups. Results In ESD group,there were 5 cases with positive horizontal margin (invasive submucosal depths exceeding 200 μm).The total resection rate was 100%,the complete resection rate was 96%,and the curative resection rate was 91%.In EPMR group,there were 3 cases with positive horizontal margin.No entire excision of lesions was conducted.There was no significant difference in comparison of horizontal margin between two groups (P>0.05).Compared with EPMR group,the operation time was the longer,and the lesions was the larger in ESD group (all P<0.01).There were no significant differences in the rates of perforation and postoperative hemorrhage,the incidence of esophageal stricture one year after operation (all P<0.05).During one-year follow-up period,the local recurrence rates were 4.21% in ESD group and 11.34% in EPMR group(χ²=3.384,P=0.066). Conclusion Endoscopic submucosal dissection is superior to endoscopic piecemeal mucosal resection in the treatment of esophageal mucosal lesions more than 15 mm in diameter.