The progressive increase in the number of endoscopic surveillance and screening procedures has been coupled with an increase in early diagnosis of esophageal cancer. The management of superficial esophageal cancers denned as lesions limited to the mucosa and submucosa has been subject to debate. This debate is rooted in the lack of sufficient clinical trials comparing long-term outcomes of esophagectomy and endoscopic resection. Although esophagectomy holds the promise of cure when performed by an experienced group, it is also limited by high morbidity and mortality. To address the issue of surgical morbidity and to comply with the minimally invasive mantra that has allowed outcome improvement in many surgical fields, endoscopic approaches are increasingly adopted, though with a lot of debate, for the treatment of early superficial esophageal cancer.
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