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Safety and feasibility of simultaneous endoscopic submucosal dissection for multiple gastric neoplasias

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 
Citation
 SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, Vol.29(12) : 3690-3697, 2015 
Journal Title
 SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES 
ISSN
 0930-2794 
Issue Date
2015
MeSH
Adenoma/surgery* ; Adult ; Aged ; Dissection/methods* ; Feasibility Studies ; Female ; Follow-Up Studies ; Gastric Mucosa/surgery* ; Gastroscopy/methods* ; Humans ; Male ; Middle Aged ; Neoplasms, Multiple Primary/surgery* ; Retrospective Studies ; Safety ; Stomach Neoplasms/surgery* ; Treatment Outcome
Keywords
Endoscopic submucosal dissection ; Multiple gastric neoplasms ; Outcomes
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.
Full Text
https://link.springer.com/article/10.1007%2Fs00464-015-4139-4
DOI
10.1007/s00464-015-4139-4
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Hyunki(김현기) ORCID logo https://orcid.org/0000-0003-2292-5584
Park, Jun Chul(박준철) ORCID logo https://orcid.org/0000-0001-8018-0010
Shin, Sung Kwan(신성관) ORCID logo https://orcid.org/0000-0001-5466-1400
Lee, Sang Kil(이상길) ORCID logo https://orcid.org/0000-0002-0721-0364
Lee, Yong Chan(이용찬) ORCID logo https://orcid.org/0000-0001-8800-6906
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/157318
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