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

Title
Safety and feasibility of simultaneous endoscopic submucosal dissection for multiple gastric neoplasias
Authors
박찬혁
Keywords
Endoscopic submucosal dissection; Multiple gastric neoplasms; Outcomes
Issue Date
2015-03
Publisher
SPRINGER
Citation
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, v. 29, NO 12, Page. 3690-3697
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.
URI
http://link.springer.com/article/10.1007/s00464-015-4139-4http://hdl.handle.net/20.500.11754/22799
ISSN
0930-2794; 1432-2218
DOI
http://dx.doi.org/10.1007/s00464-015-4139-4
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COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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