Gastroenterologie
a hepatologie

Short-term outcomes of endoscopic submucosal dissection (ESD) for gastric superficial neoplastic lesions

Ondřej Urban ^{Orcid.org  1,2}, Petr Fojtík ^{Orcid.org  3}, Přemysl Falt ^{Orcid.org  4}, Martin Kliment ^{Orcid.org  5}, Ota Mikolajek ^{Orcid.org  6}, Miloslav Mazur⁷, Aleš Foltys⁷, Pavol Holéczy ^{Orcid.org  8,9}, Romana Andělová¹⁰, Martin Baník¹¹, Ivo Kasperčík ^{Orcid.org  11}, Petr Barabáš¹², Jaromír Richter ^{Orcid.org  12}

+ Affiliation
¹ II. interní klinika – gastroenterologie a geriatrie LF UP a FN Olomouc
² Katedra interních oborů, LF UK v Hradci Králové
³ Centrum péče o zažívací trakt, Vítkovická nemocnice a. s., Ostrava
⁴ II. interní klinika – gastroenterologická a geriatrická, LF UP a FN Olomouc
⁵ Gastroenterologie und Hepatologie, Klinik für Innere Medizin, Vivantes Klinikum Spandau, Berlin, Germany 2 Research Institute AGEL, Digestive Disease Center, Vitkovice Hospital, Ostrava, Czech Republic
⁶ Vzdělávací a výzkumný institut AGEL, o.p.s., Centrum péče o zažívací trakt, Vítkovická nemocnice a. s., Ostrava
⁷ Centrum péče o zažívací trakt, Vzdělávací a výzkumný institut AGEL, o.p.s., Vítkovická nemocnice a. s., Ostrava
⁸ Katedra chirurgických oborů, LF OU v Ostravě
⁹ Chirurgické oddělení, Vítkovická nemocnice a. s., Ostrava
¹⁰ Komplexní onkologické centrum Nový Jičín
¹¹ Patologie, Laboratoře AGEL a. s., Nový Jičín
¹² Komplexní onkologické centrum, Nový Jičín

Summary

The paper presents a prospectively evaluated group of 25 patients treated by gastric endoscopic submucosal dissection (G-ESD). The aim of the study was to evaluate short-term treatment results. Methods: All patients treated by G-ESD during the study period 11/2011–10/2014 were included in the study. Lesions were indicated for G-ESD according to expanded criteria. En bloc resection, R0 resection, curative resection and complications were considered as indicators of short-term treatment results. Results: A total of 20 (80%) of lesions were neoplastic according to the final histological evaluation. Among them, en bloc, R0 and curative resection could be achieved in 17 (85%), 17 (85%) and 16 (80%) respectively. Perforation was observed in two (8%) of all cases and had to be treated surgically in one (4%) case. The 30-day mortality was 0. Conclusions: The paper presents the treatment results of a series of the first group of G-ESD patients from a Czech gastroenterology center. Our results are similar to those reported from Eastern-Asia centers. Nevertheless, the validity of the results is limited by a selection bias.

Keywords

Ro resection, gastric cancer, endsocopic submucosal dissection

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Literature

Literatura
1. Jemal A, Bray F, Center MM et al. Global cancer statistics. CA Cancer J Clin 2011; 61(2): 69– 90. doi: 10.3322/ caac.20107.
2. Česká onkologická společnost ČLS JEP. [online]. Dostupné z: http:/ / www.linkos.cz/ .
3. Kodera Y, Sasako M, Yamamoto S et al. Identification of risk facors for the development of complications following extended and superextended lymphadenectomies for gastric cancer. Br J Surg 2005; 92(9): 1103– 1109.
4. Chiu PW, Teoh HY, To KF et al. Endoscopic submucosal dissection (ESD) compared with gastrectomy for treatment of early gastric neoplasia: a retrospective cohort study. Surg Endosc 2012; 26(12): 3584– 3591. doi: 10.1007/ s00464‑ 012‑ 2371‑ 8.
5. Gotoda T, Yanagisawa A, Sasako M et al.
Incidence of lymph node metastasis from early gastric cancer: estimation with a large number of cases at two large centers. Gastric Cancer 2000; 3(4): 219– 225.
6. Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2010 (ver. 3). Gastric Cancer 2011; 14(2): 113– 123. doi: 10.1007/ s10120‑ 011 ‑ 0042‑ 4.
7. Ono H, Kondo H, Gotoda T et al. Endoscopic mucosal resection for treatment of early gastric cancer. Gut 2001; 48(2): 225– 229.
8. Ohkuwa M, Hosokawa K, Boku N et al. New endoscopic treatment for intramucosal gastric tumors using an insulated‑ tip diathermic knife. Endoscopy 2001; 33(3): 221– 226.
9. Ganjoho.jp [online in Japanese]. Available from: http:/ / ganjoho.jp/ public/ statistics/ pub/ statistics01.html.
10. Urban O, Vítek P, Fojtík P et al. Endoscopic submucosal dissection. Initial experience in the Czech Republic. Folia Gastroenterol Hepatol 2006; 4(1): 4– 10.
11. Jung H, Bae JM,Choi MG et al. Surgical outcome after incomplete endoscopic submucosal dissection of gastric cancer. Br J Surg 2011; 98(1): 73– 78. doi: 10.1002/ bjs.7274.
12. Lian J, Chen S, Zhang Y et al. A meta‑
-analysis of endoscopic submucosal dissection and EMR for early gastric cancer. Gastrointest Endosc 2012; 76(4): 763– 770. doi: 10.1016/ j.gie.2012.06.014.
13. Park YM, Cho E, Kang HY et al. The effectiveness and safety of endoscopic submucosal dissection compared with endoscopic mucosal resection for early gastric cancer: a systematic review and metaanalysis. Surg Endosc 2011; 25(8): 2666– 2677. doi: 10.1007/ s00464‑ 011‑ 1627‑ z.
14. Pimentel‑ Nunes P, Mourao F, Veloso N et al. Long‑term follow‑up after endoscopic resection of gastric superficial neoplastic lesions in Portugal. Endoscopy 2014; 46(11): 933– 940. doi: 10.1055/ s‑ 0034‑ 1377348.
15. Toyokawa T, Inaba T, Omote S et al. Risk factors for perforation and delayed bleeding associated with endoscopic submucosal dissection for early gastric neoplasms: analysis of 1123 lesions. J Gastroenterol Hepatol 2012; 27(5): 907– 912. doi: 10.1111/ j.1440‑ 1746.2011.07039.x.