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Updated evidence on endoscopic resection of early gastric cancer from Japan
Mitsuhiro Fujishiro1, Shuntaro Yoshida2, Rie Matsuda2
1Department of Endoscopy and Endoscopic Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. mtfujish-kkr@umin.ac.jp.
Background:
Endoscopic resection for early gastric cancer (EGC) plays a central role in the treatment of EGC in Japan. However, there is still room for improvement, and it is necessary to summarize the recently obtained knowledge from Japan for further improvement.
Methods:
We conducted a PubMed search to select relevant articles in the 5 years until September 18, 2016, using the keywords "gastric cancer" and "endoscopic treatment," "endoscopic submucosal dissection," "endoscopic mucosal resection," or "polypectomy" and filtering article types as "clinical study" or "clinical trial."
Results:
Among the 329 articles selected automatically from the keywords "polypectomy" (1 article), "endoscopic mucosal resection" (29 articles), "endoscopic submucosal dissection" (77 articles), and "endoscopic treatment" (222 articles) in combination with "gastric cancer," 32 relevant articles from Japanese investigators were chosen. Seven articles were categorized into "equipment," 4 into "preparation and sedation," 17 into "complications and their prevention," and 4 into "therapeutic outcomes." Among them, CO2 insufflation, propofol sedation, and how to prevent post-endoscopic submucosal dissection (ESD) ulcer bleeding and achieve post-ESD ulcer healing were intensively investigated. Long-term outcomes of endoscopic mucosal resection and ESD were also reported as favorable outcomes.
Conclusions:
Endoscopic resection for EGC is still developing toward an ideal form, pursuing a more reliable, safer, and faster minimally invasive treatment.
