Endoscopy 2014; 46(08): 645-649
DOI: 10.1055/s-0034-1365454
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Endoscopic submucosal dissection for gastric tumors in various types of remnant stomach

Toshiyasu Ojima
Second Department of Surgery, Wakayama Medical University, Wakayama, Japan
,
Katsunari Takifuji
Second Department of Surgery, Wakayama Medical University, Wakayama, Japan
,
Masaki Nakamura
Second Department of Surgery, Wakayama Medical University, Wakayama, Japan
,
Mikihito Nakamori
Second Department of Surgery, Wakayama Medical University, Wakayama, Japan
,
Masahiro Katsuda
Second Department of Surgery, Wakayama Medical University, Wakayama, Japan
,
Takeshi Iida
Second Department of Surgery, Wakayama Medical University, Wakayama, Japan
,
Keiji Hayata
Second Department of Surgery, Wakayama Medical University, Wakayama, Japan
,
Makoto Iwahashi
Second Department of Surgery, Wakayama Medical University, Wakayama, Japan
,
Hiroki Yamaue
Second Department of Surgery, Wakayama Medical University, Wakayama, Japan
› Author Affiliations
Further Information

Publication History

submitted 29 July 2013

accepted after revision 19 February 2014

Publication Date:
28 April 2014 (online)

Background and study aims: The aim of this study was to examine the clinical outcomes of endoscopic submucosal dissection (ESD) for gastric tumors in various types of remnant stomach.

Patients and methods: Between January 2002 and March 2013, ESD was performed for 750 gastric tumors. Of these lesions, 49 were in a remnant stomach, and were included in the study.

Results: The en bloc resection rate was 100 %. The curative resection rate was 82 %. The rate of perforation was high in patients with gastric conduits (28.6 %). Perforation was significantly more common in patients with lesions located on the suture line (4.9 % vs. 50.0 %; P = 0.0043).

Conclusion: ESD for gastric tumors in the remnant stomach can be considered feasible and safe in clinical practice. However, the procedure is technically more difficult in patients with a gastric conduit, due to the increased risk of perforation at the suture line.

 
  • References

  • 1 Ojima T, Takifuji K, Nakamura M et al. Complications of endoscopic submucosal dissection for gastric noninvasive neoplasia: an analysis of 647 lesions. Surg Laparosc Endosc Percutan Tech In press 2014;
  • 2 Ojima T, Iwahashi M, Nakamori M et al. Clinicopathological characteristics of remnant gastric cancer after a distal gastrectomy. J Gastrointest Surg 2010; 14: 277-281
  • 3 Hoteya S, Iizuka T, Kikuchi D et al. Clinical advantages of endoscopic submucosal dissection for gastric cancers in remnant stomach surpass conventional endoscopic mucosal resection. Dig Endosc 2010; 22: 17-20
  • 4 Hirasaki S, Kanzaki H, Matsubara M et al. Treatment of gastric remnant cancer post distal gastrectomy by endoscopic submucosal dissection using an insulation-tipped diathermic knife. World J Gastroenterol 2008; 14: 2550-2555
  • 5 Takenaka R, Kawahara Y, Okada H et al. Endoscopic submucosal dissection for cancers of the remnant stomach after distal gastrectomy. Gastrointest Endosc 2008; 67: 359-363
  • 6 Osumi W, Fujita Y, Hiramatsu M et al. Endoscopic submucosal dissection allows less-invasive curative resection for gastric tube cancer after esophagectomy – a case series. Endoscopy 2009; 41: 777-780
  • 7 Lee JY, Choi IJ, Cho SJ et al. Endoscopic submucosal dissection for metachronous tumor in the remnant stomach after distal gastrectomy. Surg Endosc 2010; 24: 1360-1366
  • 8 Nonaka S, Oda I, Makazu M et al. Endoscopic submucosal dissection for early gastric cancer in the remnant stomach after gastrectomy. Gastrointest Endosc 2013; 78: 63-72
  • 9 Nishide N, Ono H, Kakushima N et al. Clinical outcomes of endoscopic submucosal dissection for early gastric cancer in remnant stomach or gastric tube. Endoscopy 2012; 44: 577-583
  • 10 Soetikno R, Kaltenbach T, Yeh R et al. Endoscopic mucosal resection for early cancers of the upper gastrointestinal tract. J Clin Oncol 2005; 23: 4490-4498
  • 11 Edge SB, Byrd DR, Compton CC et al. AJCC cancer staging manual. 7th edn. New York: Springer; 2009
  • 12 Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 2004; 240: 205-213
  • 13 Japanese Gastric Cancer Society Eds. Guidelines for diagnosis and treatment of carcinoma of the stomach. Tokyo: Kanehara Shuppan; 2010
  • 14 Nonaka S, Saito Y, Takisawa H et al. Safety of carbon dioxide insufflation for upper gastrointestinal tract endoscopic treatment of patients under deep sedation. Surg Endosc 2010; 24: 1638-1645