Successful endoscopic submucosal dissection for early gastric cancer adjacent to gastric cardia varix

Abstract

A 58 -year -old man with liver cirrhosis and renal failure was diagnosed with esophageal varices (EVs) and a gastric cardia varix (GCV) by esophagogastroduodenoscopy (EGD). The patient also exhibited early gastric cancer (EGC) in the upper gastric body adjacent to the GCV. The EVs and GCV were treated using endoscopy before endoscopic submucosal dissection (ESD) of the EGC to prevent variceal bleeding during ESD. Endoscopic variceal ligation (EVL) was performed to treat the EVs. In addition, extra -variceal polidocanol injection and argon plasma coagulation (APC) were performed after EVL. Follow -up EGD two months after APC revealed that the GCV had diminished in size. Then, ESD was performed with polidocanol injection into the submucosa around the GCV to prevent bleeding. During ESD, the EGC was resected en bloc without severe bleeding. Complications were not observed after ESD. Histopathological examination of the ESD specimens indicated that the resection was curative.

Gastrointestinal Cancers and Liver Cirrhosis: Implications on Treatments and Prognosis

“…In the study, LC patients had complications of bleeding and perforation (28) (42). In addition, many studies have also proved that ESD is effective and can achieve a high overall resection rate (30,31).…”

“…evaluated the safety and effectiveness of ESD, and they confirmed that it is safe for EGC patients with LC to receive ESD, and ESD can effectively control the bleeding caused by CTP B or C cirrhosis during surgery ( 42 ). In addition, many studies have also proved that ESD is effective and can achieve a high overall resection rate ( 30 , 31 ).…”