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DOI: 10.1055/s-2006-944809
Endoscopic submucosal dissection for early gastric cancers and large flat adenomas
Publication History
Submitted 21 June 2006
Accepted after revision 3 July 2006
Publication Date:
20 October 2006 (online)
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.
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S. Kakizaki, M. D., PhD
Department of Medicine and Molecular Science
Gunma University Graduate School of Medicine · 3-39-15 Showa-machi · Maebashi, Gunma 371-8511 · Japan
Fax: +81-27-2208136·
Email: kakizaki@showa.gunma-u.ac.jp