Endoscopic submucosal dissection for early gastric cancers and large flat adenomas

Endoscopy. 2006 Oct;38(10):980-6. doi: 10.1055/s-2006-944809.

Abstract

Background and study aim: Endoscopic submucosal dissection (ESD) is a new diagnostic and treatment technique for early gastric cancer (EGC). The present study aims to identify the technical feasibility, operation time, and complications associated with ESD.

Methods: We reviewed the patients who underwent ESD for EGCs at Maebashi Red Cross Hospital.

Results: There were 160 patients with 171 EGCs treated by ESD. The mean age was 71.4 +/- 8.9 years (median 72). The rate for one-piece resection with tumor-free margins was 94.2 % (161/171), and was 93.2 % (82/88) for large lesions (> 20 mm) and 92.1 % (35/38) for ulcerative lesions. The median operation time was 80 min (range 10-600 min). Evidence of immediate bleeding was found in 2.9 % (5/171), delayed bleeding was seen in 7.6 % (13/171), and perforation was observed in 3.5 % (6/171) of the lesions. All patients with complications, including perforation, were successfully treated endoscopically. There were no local or distant metastases in the lesions which met our indication criteria for ESD.

Conclusion: The present study shows the technical feasibility of ESD, which provides the capability of one-piece resection even in large and ulcerative lesions.

MeSH terms

  • Adenoma / pathology
  • Adenoma / surgery*
  • Aged
  • Aged, 80 and over
  • Endoscopy, Gastrointestinal / methods*
  • Female
  • Gastric Mucosa / surgery*
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / surgery*
  • Time Factors
  • Treatment Outcome