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Published on: February 19, 2022
Endoscopic Submucosal Dissection of Gastric Epithelial Neoplasms after Partial Gastrectomy: A Single-Center
Byeong Gu Song1, Gwang Ha Kim1, Bong Eun Lee1
1Department of Internal Medicine, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan 49241, Republic of Korea.
Aims:
To investigate the feasibility and safety of endoscopic submucosal dissection (ESD) of gastric epithelial neoplasms in the remnant stomach (GEN-RS) after various types of partial gastrectomy.
Methods:
This study included 29 patients (31 lesions) who underwent ESD for GEN-RS between March 2006 and August 2016. Clinicopathologic data were retrieved retrospectively to assess the therapeutic ESD outcomes, including en bloc and complete resection rates and procedure-related adverse events.
Results:
The en bloc, complete, and curative resection rates were 90%, 77%, and 71%, respectively. The types of previous gastrectomy, tumor size, macroscopic type, and tumor histology were not associated with incomplete resection. Only tumors involving the suture lines from the prior partial gastrectomy were significantly associated with incomplete resection. The procedure-related bleeding and perforation rates were 6% and 3%, respectively; none of the adverse events required surgical intervention. During a median follow-up period of 25 months (range, 6-58 months), there was no recurrence in any case.
Conclusions:
ESD is a safe and feasible treatment for GEN-RS regardless of the previous gastrectomy type. However, the complete resection rate decreases for lesions involving the suture lines.
Insights
Endoscopic submucosal dissection (ESD) is a safe and feasible treatment for gastric epithelial neoplasms in the remnant stomach (GEN-RS). Complete resection rates decrease for GEN-RS involving suture lines from prior gastrectomy.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Endoscopic Surgery
Background:
- Gastric epithelial neoplasms in the remnant stomach (GEN-RS) present unique challenges for treatment.
- Previous partial gastrectomy can complicate the management of GEN-RS.
Purpose of the Study:
- To evaluate the feasibility and safety of endoscopic submucosal dissection (ESD) for GEN-RS.
- To assess the outcomes of ESD in patients with a history of partial gastrectomy.
Main Methods:
- Retrospective analysis of 29 patients (31 lesions) who underwent ESD for GEN-RS.
- Evaluation of en bloc, complete, and curative resection rates.
- Assessment of procedure-related adverse events and recurrence rates.
Main Results:
- En bloc, complete, and curative resection rates were 90%, 77%, and 71%, respectively.
- Procedure-related bleeding and perforation rates were 6% and 3%, with no surgical interventions required.
- No recurrence was observed during a median follow-up of 25 months.
Conclusions:
- ESD is a safe and feasible therapeutic option for GEN-RS, irrespective of prior gastrectomy type.
- Lesions involving suture lines from previous gastrectomy were associated with a decreased complete resection rate.
