Objective To evaluate the clinical efficacy,feasibility and safety of endoscopic submucosal dissection (ESD)for gastroesophageal junction lesions (GEJ). Method We retrospectively investigated the clinical data of 20 cases of gastroesophageal junction lesions diagnosed by gastroscopy and endoscopic ultrasonography(EUS),followed by resected by ESD at our Gastroenterology department from October 2010 to September 2014. The surgical procedure,intraoperative and postoperative complications during followup,and clinical efficacy were summarized. Results Of all the 20 patients,14 cases were proved to originate from the mucosal layer,1 from muscularis mucosal layer,1 from submucosal layer,and 4 from muscularis propria layer,respectively. All patients could tolerate surgery. Among them,15 cases were resected en bloc and the remaining 5 cases were resected piecemeal. The average lesion diameter was 1. 76cm(range 1. 0 ~4. 5 cm), the average operation time was 84 min(range 30 ~ 180min). There were no complications including delayed bleeding,perforation,pneumoperitoneum,mediastinal emphysema,and there was no need for additional surgery. Postoperative pathologic results were 10 hyperplastic polyps,4 leiomyomas,2 inflammation, 1 moderate dysplasia and 1 ulcer,1 tubular adenomatous polyp,1 leiomyosarcoma. Endoscopic review within1 to 3 months after ESD in 18 of 20 patients showed no residue. Conclusion ESD with the advantages of a high en bloc resection rate,a low residual and complication rate,is a safe,effective,minimally invasive, feasible treatment for lesions at GEJ.

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