Endoscopic submucosal dissection allows less-invasive curative resection for gastric tube cancer after esophagectomy – a case series

Osumi, Wataru; Fujita, Yuriko; Hiramatsu, Masako; Kawai, Masaru; Sumiyoshi, Kenichi; Umegaki, Eiji; Tokioka, Satoshi; Yoda, Yusuke; Egashira, Yasuyuki; Abe, Seiichiro; Higuchi, K; Tanigawa, N

doi:10.1055/s-0029-1215024

Cited by 25 publications

(23 citation statements)

References 9 publications

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“…ESD offers advantages in terms of the shape and size of the resectable lesions compared with conventional EMR and has enabled successful en bloc resection of various cancers [2][3][4]. Several reports have indicated that a high en bloc resection rate was achieved by ESD in the remnant stomach, despite some technical difficulties [5][6][7][8][9]. Lesions located at anastomotic sites are expected to be much more difficult because there are severe fibrosis and staples from the previous surgery, and because there is the need for resection of duodenal or small intestinal mucosa.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic submucosal dissection for early gastric cancer in anastomosis site after distal gastrectomy

et al. 2013

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Background Detection of early gastric cancer (EGC) in the remnant stomach is increasing because of follow-up endoscopic surveillance programs. Endoscopic treatment appears to be desirable for EGC in the remnant stomach because it is less invasive than surgical resection. Methods In this retrospective study, to evaluate the feasibility of endoscopic submucosal dissection (ESD) for EGC in an anastomotic site, treatment results of ESD for EGC in an anastomotic site and in remnant stomach not involving an anastomotic site were compared. In total, 11 EGC lesions of anastomotic sites in 11 patients and 22 EGC lesions of remnant stomach not involving an anastomotic site in 21 patients were treated by ESD. Results All lesions were successfully treated by en bloc resection. There were three patients with perforations in the anastomotic site group. Although resected specimen size and tumor size were larger in the anastomotic site group than in the non-anastomotic site group (P \ 0.01), the procedure duration was far longer in the anastomotic site group than in the non-anastomotic site group (P \ 0.01). The speed of the procedure was faster in the nonanastomotic site group than in the anastomotic site group (P \ 0.05). Conclusions Although ESD for EGC in an anastomotic site is a time-consuming procedure and requires advanced techniques compared with ESD for EGC not involving an anastomotic site, a high en bloc resection rate was achieved. ESD by endoscopists with sufficient experience appears to be a feasible treatment for EGC in an anastomotic site.

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Section: Introductionmentioning

confidence: 99%

Endoscopic submucosal dissection for early gastric cancer in anastomosis site after distal gastrectomy

et al. 2013

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“…In addition, delayed perforations did not occur in any case. However, the possibility of delayed perforation should not be ignored in fibrotic areas that are subjected to excessive electrocautery effects [23]. In the future, additional large studies are required to demonstrate the influence of the tumor's involvement with the suture lines on the increased risk of perforation during ESD for GEN-RS.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Submucosal Dissection of Gastric Epithelial Neoplasms after Partial Gastrectomy: A Single-Center Experience

Song

Kim

Lee

et al. 2017

Gastroenterology Research and Practice

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Aims To investigate the feasibility and safety of endoscopic submucosal dissection (ESD) of gastric epithelial neoplasms in the remnant stomach (GEN-RS) after various types of partial gastrectomy. Methods This study included 29 patients (31 lesions) who underwent ESD for GEN-RS between March 2006 and August 2016. Clinicopathologic data were retrieved retrospectively to assess the therapeutic ESD outcomes, including en bloc and complete resection rates and procedure-related adverse events. Results The en bloc, complete, and curative resection rates were 90%, 77%, and 71%, respectively. The types of previous gastrectomy, tumor size, macroscopic type, and tumor histology were not associated with incomplete resection. Only tumors involving the suture lines from the prior partial gastrectomy were significantly associated with incomplete resection. The procedure-related bleeding and perforation rates were 6% and 3%, respectively; none of the adverse events required surgical intervention. During a median follow-up period of 25 months (range, 6–58 months), there was no recurrence in any case. Conclusions ESD is a safe and feasible treatment for GEN-RS regardless of the previous gastrectomy type. However, the complete resection rate decreases for lesions involving the suture lines.

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“…Therefore, it is not surprising that mucosally based neoplastic lesions such as esophageal squamous cancers, adenocarcinomas associated with Barrett’s esophagus, and gastric cancers are the most common targets for this therapy in the upper gastrointestinal tract [2–4]. Less common usages would be for the removal of submucosal lesions such as leiomyomas or GIST [5].…”

Section: Indications For Proceduresmentioning

confidence: 99%

Endoscopic mucosal resection and endoscopic submucosal dissection in esophageal and gastric cancers

Wang

Prasad²,

Tian

2010

Current Opinion in Gastroenterology

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Purpose of review To summarize the literature to date on endoscopic mucosal removal techniques as applied to the upper gastrointestinal tract, predominantly the stomach and esophagus. This is an area that has rapidly advanced in terms of new procedures and techniques with a large body of outcomes that support their use. Recent findings The resection techniques can be divided into two forms, mucosal resection and submucosal dissection. Mucosal resection is typically done with cap techniques and is more suitable for removable of neoplastic lesions that are less than 1.5 cm in size. Submucosal dissection techniques are more difficult, associated with increased complications, and typically reserved for lesions greater than 1.5 cm and less than 3 cm in size. Ideal lesions for mucosal resection are generally flat and are located in areas easily accessible by the endoscope. Summary Endoscopic tissue removal methods are capable of removing neoplastic lesions en bloc in the upper gastrointestinal tract. These techniques fulfill cancer treatment guidelines by having histological confirmation of total removal of neoplastic lesions with assessment of the margins of resections. Long-term clinical outcomes of these techniques are emerging and seem promising in terms of disease-free and overall survival.

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Endoscopic submucosal dissection allows less-invasive curative resection for gastric tube cancer after esophagectomy – a case series

Cited by 25 publications

References 9 publications

Endoscopic submucosal dissection for early gastric cancer in anastomosis site after distal gastrectomy

Endoscopic submucosal dissection for early gastric cancer in anastomosis site after distal gastrectomy

Endoscopic Submucosal Dissection of Gastric Epithelial Neoplasms after Partial Gastrectomy: A Single-Center Experience

Endoscopic mucosal resection and endoscopic submucosal dissection in esophageal and gastric cancers

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