Safety and Feasibility of Simultaneous Endoscopic Submucosal Dissection for Multiple Gastric Neoplasias

Overview

Journal Surg Endosc

Publisher Springer

Specialties Gastroenterology
General Surgery
Radiology

Date 2015 Mar 19

PMID 25783832

Citations 4

Authors

Dong Hoo Joh

Chan Hyuk Park

Sungmo Jung

Seung-Ho Choi

Hyun Ki Kim

Hyuk Lee

Jun Chul Park

Sung Kwan Shin

Yong Chan Lee

Sang Kil Lee

Affiliations

Soon will be listed here.

Abstract

Background: Synchronous gastric neoplasms are not infrequently detected, thus endoscopic submucosal dissection (ESD) for multiple early gastric neoplasia is occasionally considered. However, there have been few investigations of the safety and feasibility of simultaneous ESD for multiple gastric lesions. This study aims to evaluate the safety and feasibility of simultaneous ESD for multiple gastric neoplasia.

Methods: A total of 1823 patients who underwent ESD for 1929 gastric adenomas or early gastric cancers were retrospectively reviewed in this study. Two hundred gastric adenomas or early gastric cancers among 94 patients were treated by ESD simultaneously (multiple group), and 1729 patients were treated with ESD for a single lesion (single group).

Results: En bloc resection (P = 0.060), complete resection (P = 0.362) and curative resection (P = 0.108) rates did not differ between the two groups. Rates of adverse events including bleeding (P = 0.317), perforation (P = 0.316) and aspiration pneumonia (P = 0.563) were not higher in the multiple group. Long-term follow-up showed more frequent local recurrence (P < 0.001), synchronous neoplasia (P = 0.041) and metachronous neoplasia (P < 0.001) per patient in the multiple group; however, local recurrence per lesion did not differ between the two groups (P = 0.103).

Conclusions: Simultaneous ESD for multiple synchronous gastric neoplasms is safe and feasible compared to single ESD. However, thorough examination for local recurrence and synchronous and metachronous neoplasia is required.

Citing Articles

Comparison of clinical outcomes and prognosis between surgery and endoscopic submucosal dissection in patients with synchronous multifocal early gastric cancer.

Bao L, Gao H, Pu L, Sui C, Ji K, Wang F BMC Surg. 2023; 23(1):292.

PMID: 37752470 PMC: 10521562. DOI: 10.1186/s12893-023-02194-1.

Comparing outcomes for endoscopic submucosal dissection between Eastern and Western countries: A systematic review and meta-analysis.

Daoud D, Suter N, Durand M, Bouin M, Faulques B, von Renteln D World J Gastroenterol. 2018; 24(23):2518-2536.

PMID: 29930473 PMC: 6010943. DOI: 10.3748/wjg.v24.i23.2518.

Simultaneous endoscopic submucosal dissection for multiple early gastric cancers in a low volume center.

Chen Z, Jin X, Wu H, Guo J Medicine (Baltimore). 2017; 96(36):e7745.

PMID: 28885329 PMC: 6393059. DOI: 10.1097/MD.0000000000007745.

Safety and efficacy of simultaneous colorectal ESD for large synchronous colorectal lesions.

Chiba H, Tachikawa J, Kurihara D, Ashikari K, Goto T, Takahashi A Endosc Int Open. 2017; 5(7):E595-E602.

PMID: 28670616 PMC: 5482740. DOI: 10.1055/s-0043-110567.

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