Figure 2

In Case 5, complete circular ESD was achieved, and oral prednisolone was given. He has not required any EBD sessions without no postprocedural stricture and the related dysphagia. A. Chromoendoscopy with iodine staining revealed a discolored area spreading to involve nearly the entire circumference of the esophagus in the middle thoracic esophagus (Case 5, Table 1), and wholly circumferential, endoscopic submucosal dissection was performed. B. Artificial ulcer immediately after complete circular resection. Complete circular resection was achieved (C), and the tumor was removed en bloc with tumor-free lateral and basal margins (D). Histopathological assessment revealed intramucosal invasive squamous cell carcinoma (m2). Oral prednisolone (30 mg) was initiated on the third postoperative day, tapered, and then discontinued 8 weeks later. E. Follow-up endoscopy 6 months later revealed no postprocedural stricture without EBD.