Disección submucosa endoscópica en cáncer gástrico incipiente: experiencia inicial en el Hospital Clínico de la Pontificia Universidad Católica de Chile

D, Andrés Donoso; Sharp, Allan; Parra‐Blanco, Adolfo; Roa, Juan Carlos; Bächler, Jean Phillipe; Crovari, Fernando; Funke, Ricardo; Pimentel, Fernando; Ibáñez, Luis; Guzmán, Sergio

doi:10.4067/s0034-98872015001000006

Cited by 7 publications

(3 citation statements)

References 26 publications

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“…No further studies were identified among the 2610 citations available on Google Scholar. Therefore, data of 22 studies were eventually available [6–27]. In detail, there were 15 studies performed in Europe, six in Latina America, and one in Canada, with a total of 1152 patients (males: 52%; mean age: 68.5 years) and 1210 lesions, including 697 EGC, 484 dysplasia, 13 neuroendocrine tumor, and 16 with other lesions.…”

Section: Resultsmentioning

confidence: 99%

Endoscopic submucosal dissection of gastric neoplastic lesions in Western countries: systematic review and meta-analysis

Zullo

Manta²,

Francesco

et al. 2020

European Journal of Gastroenterology &Amp; Hepatology

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Endoscopic submucosal dissection (ESD) for gastric neoplastic lesions removal is largely performed in Asian countries. Unfortunately, ESD diffusion, particularly for gastric lesion removal, is still limited in Western countries. We performed a systematic review of available data coming from Western centers. The en bloc and the R0 resection rates for all neoplastic lesions, including early gastric cancer (EGC) and dysplasia, were calculated, as well as the curative rate for EGC. Complications and the 1-month mortality rates were computed. A total of 22 studies from Europe (N = 15), Latina America (N = 6), and Canada (N = 1) were retrieved, with 1152 patients and 1210 lesions. The en bloc resection was successful in 96% [95% confidence interval (CI) 93–98] with a significant heterogeneity (I 2 = 63.5%; P < 0.0001). The R0 was achieved in 84% (95% CI 79–89; I 2 = 79.9%; P < 0.001). The resection rate was curative in 72% out of 340 patients with EGC (95% CI 65–79, I 2 = 8%; P = 0.36). Overall, complications occurred in 9.5% of patients, including bleeding (5.8%), perforation (3.4%), and stenosis (0.35%). A total of three (0.26%) patients deceased within 1 month, but none was directly related to the procedure. Lesion recurrence was observed in 38 (3.5%; 95% CI 2.3–4.4) cases, including 21 EGC and 17 dysplasia. In Western countries, the en bloc and the R0 resections were successful in the large majority of cases, whilst the resection was curative in 72% of patients with EGC. The complications rate was acceptably low.

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Section: Resultsmentioning

confidence: 99%

Endoscopic submucosal dissection of gastric neoplastic lesions in Western countries: systematic review and meta-analysis

Zullo

Manta²,

Francesco

et al. 2020

European Journal of Gastroenterology &Amp; Hepatology

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“…Los reportes en centros de occidente y en particular en nuestro país son más escasos 21,22 . El objetivo de este trabajo es describir la experiencia y resultados de un cirujano en pacientes con CGI sometidos a disección submucosa.…”

Section: Introductionunclassified

Desarrollo de la técnica de disección submucosa endoscópica en cáncer gástrico incipiente. Primeros cincuenta casos de un cirujano.

Martínez

2020

Rev. Cirugia

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Introduccion:El cáncer gástrico es un problema de salud en Chile y su mal pronóstico global se explica por un diagnóstico en etapas avanzadas. El cáncer gástrico incipiente (CGI) se asocia a buen pronóstico oncológico y la disección submucosa endoscópica (DSE) como alternativa de tratamiento ha demostrado ser comparable al estándar quirúrgico.Objetivo: Describir la experiencia y resultados de un cirujano en pacientes con CGI sometidos a DSE.Materiales y Métodos: Estudio retrospectivo que incluyó a los pacientes sometidos a DSE por CGI entre mayo 2015 y marzo 2019. Se tabuló información demográfica, datos perioperatorios y del seguimiento obtenidos del registro institucional. Se utilizó estadística descriptiva. Resultados: Se realizaron 52 DSE por CGI en el período analizado. La resección en bloque se logró en un 96% de los casos. La morbilidad alcanzó el 2%, no se registró mortalidad postoperatoria. 98% de las resecciones en bloque fueron consideradas R0 y un 86% de ellas cumplieron estándares de curación. La mediana de seguimiento es de 19 meses y la sobrevida específica por cáncer gástrico y libre de recurrencia alcanza el 100%. Discusión y conclusiones: La DSE es una técnica con potencial curativo en pacientes con CGI, presentando mejores resultados en términos de morbimortalidad, calidad de vida y es comparable a la cirugía en el pronóstico oncológico. Los resultados presentados son concordantes con la literatura y apoyan la implementación de la técnica para el tratamiento del CGI.

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“…El análisis de las series reportadas muestra que la DES es una técnica segura con buenos resultados oncológicos en el largo plazo 8,[12][13][14][15] . En occidente, especialmente en Latinoamérica y Chile, la experiencia reportada es escasa [16][17][18][19][20] .…”

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Disección endoscópica submucosa para el tratamiento de neoplasias incipientes del tubo digestivo: experiencia en un centro universitario de alto volumen

et al. 2021

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Experience with endoscopic submucosal dissection for the treatment of early neoplasms of the digestive tract Background: Endoscopic submucosal dissection (ESD) allows en-bloc resection of early gastro-intestinal neoplasms (EGIN) with healing potential. Aim: To describe the results of patients treated with ESD for EGIN by our team. Patients and Methods: Descriptive study of patients with EGIN who underwent ESD with curative intention between January 2008 and March 2020.Results: One hundred thirty-two ESD were performed in 127 patients. 77% were gastric lesions, 14% colorectal, 8% esophageal and 1% duodenal. En-bloc resection was achieved in 98.4% of ESDs. Eighty eight percent of patients met curative standards. Overall, cancer-specific, and recurrence-free survival were 95%, 100% and 98% respectively. Conclusions: ESD allows en-bloc resections with curative potential in selected patients, but with a significant reduction in morbidity and mortality and less impact on quality of life. Our results suggest the feasibility to perform ESD in our country with results comparable to those reported in the literature.

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Disección submucosa endoscópica en cáncer gástrico incipiente: experiencia inicial en el Hospital Clínico de la Pontificia Universidad Católica de Chile

Cited by 7 publications

References 26 publications

Endoscopic submucosal dissection of gastric neoplastic lesions in Western countries: systematic review and meta-analysis

Endoscopic submucosal dissection of gastric neoplastic lesions in Western countries: systematic review and meta-analysis

Desarrollo de la técnica de disección submucosa endoscópica en cáncer gástrico incipiente. Primeros cincuenta casos de un cirujano.

Disección endoscópica submucosa para el tratamiento de neoplasias incipientes del tubo digestivo: experiencia en un centro universitario de alto volumen

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