ANALYSIS OF ATYPICAL SCAR PATTERNS AFTER GASTRIC ENDOSCOPIC SUBMUCOSAL DISSECTION

Aims Endoscopic submucosal dissection (ESD) for gastric neoplasms is a widely performed procedure. While incidences of local recurrence are rare, various post-ESD scars are encountered during follow-up endoscopy. Therefore, we investigated atypical scar patterns and evaluated the factors associated with such a condition.

Methods Clinicopathologic and endoscopic reviews of gastric neoplasms treated with ESD between January 2009 and December 2015 were conducted. Atypical scar patterns were classified as irregular erythema, nodularity, or mucosal defect.

Results Two hundred and seventy-four gastric neoplasms, including 201 adenomas and 73 early gastric cancers, were enrolled. Irregular erythema pattern was associated with male sex (P=0.018), and nodularity pattern was associated with smoking (P=0.006). Mucosal defect pattern was associated with infra-angle location (angle and antrum) (P=0.008) and cancer (P=0.001). Additionally, irregular erythema with nodularity pattern was associated with male sex (P=0.030), and irregular erythema with nodularity and mucosal defect pattern was associated with liver disease and chronic kidney disease (P=0.015 and P=0.011, respectively).

Conclusions Distinct clinical factors had an influence on atypical scar formation after gastric ESD.