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Impact of tumor location on clinical outcomes of gastric endoscopic submucosal dissection

 Ji Young Yoon  ;  Choong Nam Shim  ;  Sook Hee Chung  ;  Wan Park  ;  Hyunsoo Chung  ;  Hyuk Lee  ;  Sung Kwan Shin  ;  Sang Kil Lee  ;  Yong Chan Lee  ;  Jun Chul Park 
 WORLD JOURNAL OF GASTROENTEROLOGY, Vol.20(26) : 8631-8637, 2014 
Journal Title
Issue Date
Aged ; Chi-Square Distribution ; Dissection/adverse effects ; Dissection/methods* ; Female ; Gastrectomy/adverse effects ; Gastrectomy/methods* ; Gastric Mucosa/pathology ; Gastric Mucosa/surgery* ; Gastroscopy/adverse effects ; Gastroscopy/methods* ; Humans ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm, Residual ; Odds Ratio ; Operative Time ; Postoperative Complications/etiology ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms/pathology ; Stomach Neoplasms/surgery* ; Time Factors ; Treatment Outcome
Complication ; Endoscopic submucosal dissection ; Gastric neoplasm ; Location ; Outcomes
AIM: To determine whether there is a correlation between the location of the lesion and endoscopic submucosal dissection (ESD) outcome. METHODS: From January 2008 to December 2010, ESD of 1443 gastric tumors was performed. En bloc resection rate, complete resection rate, procedure time and complication rate were analyzed according to the tumor location. RESULTS: The rates of en bloc resection and complete resection were 91% (1318/1443) and 89% (1287/1443), respectively. The post-ESD bleeding rate was 4.3%, and perforation rate was 2.7%. Tumors located in the upper third of the stomach were associated with a longer procedure time and significantly higher rates of incomplete resection, piecemeal resection, and perforation than tumors below the upper third of the stomach. Posterior wall lesions had significantly longer procedure times and higher rates of incomplete resection and piecemeal resection than lesions in other locations. In multivariate analysis, posterior wall lesions and upper third lesions were significantly associated with incomplete resection and perforation, respectively. In post-ESD bleeding analysis, location was not a significant related factor. CONCLUSION: More advanced endoscopic techniques are required during ESD for lesions located in the upper third or posterior wall of the stomach to decrease complications and improve therapeutic outcomes.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Park, Wan(박완)
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
Shim, Choong Nam(심충남)
Yun, Gi Young(윤지영)
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
Lee, Hyuk(이혁)
Chung, Sook Hee(정숙희)
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