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How to manage pyloric tumours that are difficult to resect completely with endoscopic resection: comparison of the retroflexion vs. forward view technique.

 Jun Chul Park  ;  Jie-Hyun Kim  ;  Yong Chan Lee  ;  Sang In Lee  ;  Hyojin Park  ;  Hoguen Kim  ;  Sang Kil Lee  ;  Sung Kwan Shin  ;  Hyuk Lee  ;  Hyunki Kim  ;  Hyunsoo Chung  ;  Kyungseok Cheoi  ;  Young Hoon Youn 
 Digestive and Liver Disease, Vol.43(12) : 958-964, 2011 
Journal Title
 Digestive and Liver Disease 
Issue Date
BACKGROUND: It is difficult to perform complete resection of prepyloric tumours, especially those involving pyloric channel due to incomplete visualisation and insufficient resection margin with forward view. AIM: To investigate outcomes of endoscopic submucosal dissection for pyloric tumours, we assess effectiveness of retroflexion view technique in comparison with forward view technique. METHODS: We investigated 47 prepyloric tumours treated by endoscopic submucosal dissection and compared results of forward view technique with those of retroflexion view technique. RESULTS: Of the 47 prepyloric tumours, 23 lesions had pyloric channel involvement (group 1) and 24 lesions did not (group 2). The en bloc resection, curative resection and complete resection rates for all endoscopic submucosal dissection cases were 80.9, 85.1 and 70.2%, respectively. The en bloc resection, curative resection and complete resection rates were significantly lower in group 1 than group 2. Of the tumours involving pyloric channel except 3 cases which were extended to duodenum, 12 lesions were resected with retroflexion and 8 lesions with forward. Curative resection rate was higher in retroflexion group than forward group (91.7% vs. 37.5%; p=0.018). None of the patients experienced perforation or pyloric stenosis. CONCLUSIONS: Endoscopic submucosal dissection using retroflexion manoeuvre is a more effective method for the curative resection of gastric tumours involving pyloric channel.
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1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실)
Yonsei Authors
김지현(Kim, Ji Hyun) ; 김현기(Kim, Hyun Ki) ; 김호근(Kim, Ho Keun) ; 박준철(Park, Jun Chul) ; 박효진(Park, Hyo Jin) ; 신성관(Shin, Sung Kwan) ; 윤영훈(Youn, Young Hoon) ; 이상길(Lee, Sang Kil) ; 이상인(Lee, Sang In) ; 이용찬(Lee, Yong Chan) ; 이혁(Lee, Hyuk) ; 최경석(Cheoi, Kyung Seok)
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