Clinical outcomes of endoscopic submucosal dissection for lesions on the proximal location between remnant and entire stomach View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2019-05-28

AUTHORS

Su Jin Kim, Cheol Woong Choi, Dae Hwan Kang, Hyung Wook Kim, Su Bum Park, Hyeong Seok Nam, Dae Gon Ryu

ABSTRACT

BackgroundTumors located on the proximal stomach are associated with a longer procedure time and lower en-block resection of endoscopic submucosal dissection (ESD). Additionally, it is more difficult to perform ESD for lesions after distal gastrectomy because of the narrow inner space. We aimed to evaluate the therapeutic outcomes of ESD for lesions on the remnant stomach compared with those on the upper third of the entire stomach.MethodsA total of 135 patients with a neoplasm located on the proximal stomach who received ESD between Aug 2008 and Dec 2016 were enrolled. We retrospectively reviewed en-bloc resection rate, complete resection rate, and complication rate according to whether distal gastrectomy was performed. Clinical outcomes were compared among the 1:2 propensity-matched groups.ResultsBetween the remnant stomach and entire stomach, the en-bloc [92% (23/25) and 92.0% (46/50), respectively; P = 1.000] and complete resection [84% (21/25) and 88.0 (44/50), respectively; P = 0.723] rates were not significantly different. In patients with lesions that indicated ESD, there was no significant difference in en-bloc and complete resection rates. In a multivariable analysis, submucosal fibrosis [odds ratio (OR) 5.9, 95% confidence interval (CI) 1.1–30.7] and submucosa invasive cancer (OR 10.1, 95% CI 1.4–74.3) were independent risk factors for incomplete resection.ConclusionsESD is a feasible therapeutic option for lesions located on the proximal stomach regardless the operation history of distal gastrectomy. However, the complete resection rate decreases for lesions with submucosal fibrosis or the submucosa invasion. More... »

PAGES

880-887

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00464-019-06844-5

DOI

http://dx.doi.org/10.1007/s00464-019-06844-5

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1115971130

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/31139997


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