Treatment Outcomes of Endoscopic Submucosal Dissection for Early Gastric Cancer with Ulceration Findings Noboru Kawata 1 , Hiroyuki Ono 1 , Masaki Tanaka 1 , Naomi Kakushima 1 , Hiroaki Sawai 1 , Kohei Takizawa 1 1Division of Digestive Endoscopy, Shizuoka Cancer Center Hospital, Shizuoka, Japan Keyword: ESD , 潰瘍合併早期胃癌 , 適応拡大病変 , UL(+) , 切れ込み pp.56-62
Published Date 2013/1/25
DOI https://doi.org/10.11477/mf.1403113700
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 A total of 2,143 cases of early gastric cancer that underwent ESD(endoscopic submucosal dissection)at our facility between September 2002 and December 2010 were classified into 428cases of early gastric cancer complicated with ulcer〔UL(+)group〕and 1,715 cases of early gastric cancer not complicated with ulcer〔UL(-)group〕, and a retrospective comparative study was performed. There were no significant differences between the two groups in en bloc resection rate or postoperative hemorrhage rate, but the UL(+)group had a significantly lower rate in en bloc margin-negative resection compared to the UL(-)group, with longer treatment time and a high rate of perforation during surgery. ESD remains difficult for early gastric cancer complicated with ulcer, and further improvements are required. In addition, there is a paucity of long-term ESD observations for early gastric cancer complicated with ulcer, and thus the procedure is often regarded as being in the clinical research stage. Depending on the skill level of the physician carrying out endoscopy, referring the patient to another facility with more experience or performing a surgical procedure without ESD may be considered. With regard to the long-term outcome, it will be necessary to wait for the results from an ongoing multicenter prospective study.

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