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

Song, Byeong Gu; Kim, Gwang Ha; Lee, Bong Eun; Jeon, Hye Kyung; Baek, Dong Hoon; Song, Geun Am

doi:10.1155/2017/6395283

Cited by 6 publications

(7 citation statements)

References 23 publications

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“…Despite the fact that many studies have investigated and discussed bleeding following gastric ESD in patients with whole stomach [ 10 , 11 , 12 , 32 ], few studies have evaluated the details of bleeding following gastric ESD in patients with surgically altered stomach, mainly due to the small numbers of cases in previous studies [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ]. Thus, the present study evaluated it using the data of a large-scale multicenter study.…”

Section: Discussion/conclusionmentioning

confidence: 99%

“…Furthermore, no studies directly compared the bleeding risk between surgically altered and whole stomach under similar baseline characteristics. All previous studies were single-institution studies with relatively small numbers of cases [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ], which may have made it difficult to clarify the details of bleeding following gastric ESD in patients with surgically altered stomach.…”

Section: Introductionmentioning

confidence: 99%

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Bleeding following Endoscopic Submucosal Dissection for Early Gastric Cancer in Surgically Altered Stomach

et al. 2022

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Introduction: Few studies have focused on bleeding following endoscopic submucosal dissection (ESD) in surgically altered stomach. We aimed to reveal the bleeding risk in surgically altered stomach following ESD for early gastric cancer (EGC). Methods: We enrolled patients with ESD for EGC at 33 institutions between 2013 and 2016. In study 1, we evaluated bleeding risk following ESD in surgically altered stomach, compared with whole stomach. In study 2, we evaluated factors associated with bleeding following ESD in patients with surgically altered stomach. Results: Of 11,452 patients, 445 patients had surgically altered stomach with the bleeding rate following ESD of 4.9%. In study 1, the bleeding risk in surgically altered stomach was not significant (odds ratio [OR], 1.37; 95% confidence interval [CI], 0.87–2.17) in the multivariate logistic regression analysis. No significant results were obtained when the surgically altered stomach was subdivided into various types. In study 2, the multivariate logistic regression analysis revealed that independent risk factors for bleeding following ESD were ischemic heart disease (OR, 7.52; 95% CI, 2.00–28.25) and P2Y12 receptor antagonist (OR, 4.81; 95% CI, 1.21–19.14). Discussion/Conclusion: In this nationwide study, we found that the bleeding risk of surgically altered stomach following ESD for EGC did not significantly differ from that of whole stomach. The risk factors for ESD in patients with surgically altered stomach were ischemic heart disease and P2Y12 receptor antagonist.

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Section: Discussion/conclusionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Bleeding following Endoscopic Submucosal Dissection for Early Gastric Cancer in Surgically Altered Stomach

et al. 2022

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“…Yabuuchi et al[47] found that the en bloc resection rate and intraoperative perforation rate were almost equal between the non-anastomosis or suture line group and the suture line group, whereas the en bloc resection rate was lower and the intraoperative perforation rate was significantly higher in the anastomosis group than in the other two groups. Song et al[46] reported that the en bloc and complete resection rates were significantly lower for the tumor located at the suture lines comparing to the tumor not (50% vs 96%, P = 0.037 and 25% vs 89%, P = 0.028).…”

Section: Endoscopic Submucosal Dissection For Gastric Stump Cancermentioning

confidence: 99%

Current controversies in treating remnant gastric cancer: Are minimally invasive approaches feasible?

Líu

et al. 2019

WJCC

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The incidence of remnant gastric cancer (RGC) is still increasing. Minimally invasive approaches including endoscopic resection, laparoscopic and robotic approaches, and function-preserving gastrectomy have been utilized as curative treatment methods for primary gastric cancer. However, adhesions and anatomical alterations due to previous gastrectomy make the use of minimally invasive approaches complicated and difficult for RGC. Application of these approaches for the treatment of RGC is still controversial. Endoscopic submucosal dissection is a favorable alternative therapy for the resection of early gastric cancer that occurs in the remnant stomach and can prevent unnecessary complications. The majority of retrospective studies have shown that endoscopic submucosal dissection is an effective and oncologically safe treatment modality for RGC. Subtotal gastrectomy could serve as a function-preserving gastrectomy for patients with early RGC and improve postoperative late-phase function. However, there are only two studies that demonstrate the feasibility and oncological efficacy of subtotal gastrectomy for RGC. The non-randomized controlled trials showed that compared to open gastrectomy, laparoscopic gastrectomy for RGC led to better short-term outcomes and similar oncologic results. Because of the rarity of RGC, future multicenter studies are required to determine the indications of minimally invasive treatment for RGC.

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“…However, with the improvement of endoscopic equipment and diagnostic capabilities, and the establishment of postgastrectomy surveillance programs for gastric cancer, increasingly more remnant gastric cancers are detected at earlier stages; in such cases, ESD is performed according to the same indication criteria as those for intact gastric cancer. ESD in the remnant stomach is technically more difficult than in the intact stomach owing to several factors, such as limited working space and the presence of severe fibrosis and staples under the suture line [9][10][11][12][13][14][15][16]. Despite these technical difficulties, previous reports have shown that a high en bloc resection rate can be achieved without complications.…”

Section: Introductionmentioning

confidence: 99%

“…Despite these technical difficulties, previous reports have shown that a high en bloc resection rate can be achieved without complications. Previous reports have shown favorable long-term ESD results for early remnant gastric cancer (ERGC), but all of them were from single-center advanced institutions, and no multicenter studies, including general hospitals, have been conducted [10,[13][14][15][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

Long-Term Outcomes of Endoscopic Submucosal Dissection for Early Remnant Gastric Cancer: A Retrospective Multicenter Study

et al. 2023

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Introduction: Favorable long-term outcomes of endoscopic submucosal dissection (ESD) for early remnant gastric cancer (ERGC) have been reported in single-center studies from advanced institutions. However, no studies have examined the long-term outcomes using a multicenter database. This study aimed to investigate the long-term outcomes of the aforementioned approach using a large multicenter database. Methods: This retrospective multicenter cohort study included 242 cases with 256 lesions that underwent ESD for ERGC between April 2009 and March 2019 across 12 centers. We investigated the long-term outcomes of these patients with the Kaplan-Meier method, and the relationship between curability, additional treatment, or hospital category, and the survival time was evaluated using the log-rank test. Results: During the median follow-up period of 48.4 months, the 5-year overall survival rate was 81.3%, and the 5-year gastric cancer-specific survival rate was 98.1%. The survival time of patients of endoscopic curability (eCura) C-2 without additional surgery was significantly shorter than the corresponding of patients of eCura A/B/C-1 and eCura C-2 with additional surgery. There was no significant difference in either overall survival or gastric cancer-specific survival rate between the high-volume and non-high-volume hospitals. Conclusion: The gastric cancer-specific survival of ESD for ERGC using a multicenter database was favorable. ESD for ERGC is widely applicable regardless of the hospital case volume. Management in accordance with the latest guidelines will lead to long-term survival.

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

Cited by 6 publications

References 23 publications

Bleeding following Endoscopic Submucosal Dissection for Early Gastric Cancer in Surgically Altered Stomach

Bleeding following Endoscopic Submucosal Dissection for Early Gastric Cancer in Surgically Altered Stomach

Current controversies in treating remnant gastric cancer: Are minimally invasive approaches feasible?

Long-Term Outcomes of Endoscopic Submucosal Dissection for Early Remnant Gastric Cancer: A Retrospective Multicenter Study

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