Risk factors for intraoperative perforation during endoscopic submucosal dissection of superficial esophageal squamous cell carcinoma

Figure 1 Clinical course of a patient who suffered intraoperative perforation during endoscopic submucosal dissection. A: Type 0-IIc tumor located in the right wall of the middle thoracic esophagus; B: During ESD, a perforation site was detected on the left wall (this image was rotated); C: Following perforation, the presence of mediastinal emphysema was observed on CT; D: This patient required a chest drain because of a massive pleural effusion on postoperative day (POD) 4; E: The closure of the perforation was not confirmed on POD 11; F: After confirmation of the closure on POD 18, oral intake was initiated. ESD: Endoscopic submucosal dissection; CT: Computed tomography.