TY - JOUR
T1 - Endoscopic submucosal dissection of early gastric neoplastic lesions
T2 - A western series
AU - Repici, Alessandro
AU - Zullo, Angelo
AU - Hassan, Cesare
AU - Spaggiari, Paola
AU - Strangio, Giuseppe
AU - Vitetta, Eva
AU - Ferrara, Elisa
AU - Malesci, Alberto
PY - 2013/11
Y1 - 2013/11
N2 - OBJECTIVE: Endoscopic submucosal dissection (ESD) has been found to be effective and safe for endoscopic removal of early gastric neoplasia in large Asian series. However, few data are available on the use of ESD in western countries. We assessed the efficacy of ESD performed in patients with early gastric neoplastic lesions. METHODS: We analyzed prospectively collected data of consecutive patients who underwent the ESD procedure for gastric neoplasia at a single Italian center. Procedure-related outcomes, including complete histological resection rate (i.e. R0 resection), immediate and late complication rate, procedure-related mortality, and follow-up were evaluated. RESULTS: Forty-two patients underwent gastric ESD. The en-bloc removal of lesions was successful in all cases, whereas R0 was achieved in 39 (92.8%) patients. A bleeding episode was observed in three (7.1%) patients, which was successfully managed by endoclip positioning. No perforations and procedure-related deaths were observed. The median follow-up period was 19 months (range: 9-53). A small residue of adenomatous lesion and a recurrent dysplastic lesion were removed by endoscopic mucosal resection in two (5%) patients. CONCLUSION: Our data are comparable with those of larger Asian series. Use of ESD for removal of gastric neoplastic lesions should be implemented in western countries.
AB - OBJECTIVE: Endoscopic submucosal dissection (ESD) has been found to be effective and safe for endoscopic removal of early gastric neoplasia in large Asian series. However, few data are available on the use of ESD in western countries. We assessed the efficacy of ESD performed in patients with early gastric neoplastic lesions. METHODS: We analyzed prospectively collected data of consecutive patients who underwent the ESD procedure for gastric neoplasia at a single Italian center. Procedure-related outcomes, including complete histological resection rate (i.e. R0 resection), immediate and late complication rate, procedure-related mortality, and follow-up were evaluated. RESULTS: Forty-two patients underwent gastric ESD. The en-bloc removal of lesions was successful in all cases, whereas R0 was achieved in 39 (92.8%) patients. A bleeding episode was observed in three (7.1%) patients, which was successfully managed by endoclip positioning. No perforations and procedure-related deaths were observed. The median follow-up period was 19 months (range: 9-53). A small residue of adenomatous lesion and a recurrent dysplastic lesion were removed by endoscopic mucosal resection in two (5%) patients. CONCLUSION: Our data are comparable with those of larger Asian series. Use of ESD for removal of gastric neoplastic lesions should be implemented in western countries.
KW - complications
KW - early neoplastic lesions
KW - endoscopic submucosal dissection
KW - stomach
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U2 - 10.1097/MEG.0b013e328364b492
DO - 10.1097/MEG.0b013e328364b492
M3 - Article
C2 - 23925276
AN - SCOPUS:84885316946
VL - 25
SP - 1261
EP - 1264
JO - European Journal of Gastroenterology and Hepatology
JF - European Journal of Gastroenterology and Hepatology
SN - 0954-691X
IS - 11
ER -