Endoscopy 2006; 38(10): 996-1000
DOI: 10.1055/s-2006-944780
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Endoscopic submucosal dissection for residual/local recurrence of early gastric cancer after endoscopic mucosal resection

S.  Oka1 , S.  Tanaka1 , I.  Kaneko2 , R.  Mouri2 , M.  Hirata2 , H.  Kanao2 , T.  Kawamura1 , S.  Yoshida1 , M.  Yoshihara2 , K.  Chayama2
  • 1Dept. of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan
  • 2Dept. of Medicine and Molecular Science, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
Further Information

Publication History

Submitted 19 May 2006

Accepted after revision 3 July 2006

Publication Date:
20 October 2006 (online)

Background and study aims: Endoscopic mucosal resection (EMR) is a widely accepted treatment for early gastric cancer; however, incomplete resection with residual local disease and recurrences continues to be a difficult problem. The aim of this study was to evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) for residual/local recurrent early gastric cancer lesions after EMR.
Patients and methods: The en bloc resection rate, histologically complete resection rate, complications, and local recurrence were assessed in 15 patients who underwent ESD for residual/local recurrent early gastric cancer lesions after EMR.
Results: The nonlifting sign after injection of a glycerin solution was positive due to scar formation in all cases. En bloc resection was attempted in all cases, with a complete resection rate of 93.3 % (14 of 15). The lesion was completely resected with histologically adequate margins in the 14 patients who received complete en bloc resection. The average operation time was 85.4 ± 52.9 min, and the mean follow-up period for all patients was 18.1 ± 7.4 months. Major bleeding during the procedure in one case was the only complication (one of 15, 6.7 %). None of the patients experienced recurrence of early gastric cancer after ESD.
Conclusions: ESD appears to be a safe and effective treatment for residual/local recurrent early gastric cancer lesions after EMR, and it is useful for histological confirmation of successful treatment.


S. Tanaka, M. D., Ph. D.

Dept. of Endoscopy

Hiroshima University Hospital · 1-2-3 Kasumi, Minami-ku · Hiroshima 734-8551 · Japan

Fax: +81-82-257-5538

Email: colon@hiroshima-u.ac.jp