How to manage pyloric tumours that are difficult to resect completely with endoscopic resection: Comparison of the retroflexion vs. forward view technique

Jun Chul Park, Jie Hyun Kim, Young Hoon Youn, Kyungseok Cheoi, Hyunsoo Chung, Hyunki Kim, Hyuk Lee, Sung Kwan Shin, Sang Kil Lee, Hoguen Kim, Hyojin Park, Sang In Lee, Yong Chan Lee

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: It is difficult to perform complete resection of prepyloric tumours, especially those involving pyloric channel due to incomplete visualisation and insufficient resection margin with forward view. Aim: To investigate outcomes of endoscopic submucosal dissection for pyloric tumours, we assess effectiveness of retroflexion view technique in comparison with forward view technique. Methods: We investigated 47 prepyloric tumours treated by endoscopic submucosal dissection and compared results of forward view technique with those of retroflexion view technique. Results: Of the 47 prepyloric tumours, 23 lesions had pyloric channel involvement (group 1) and 24 lesions did not (group 2). The en bloc resection, curative resection and complete resection rates for all endoscopic submucosal dissection cases were 80.9, 85.1 and 70.2%, respectively. The en bloc resection, curative resection and complete resection rates were significantly lower in group 1 than group 2. Of the tumours involving pyloric channel except 3 cases which were extended to duodenum, 12 lesions were resected with retroflexion and 8 lesions with forward. Curative resection rate was higher in retroflexion group than forward group (91.7% vs. 37.5%; p= 0.018). None of the patients experienced perforation or pyloric stenosis. Conclusions: Endoscopic submucosal dissection using retroflexion manoeuvre is a more effective method for the curative resection of gastric tumours involving pyloric channel.

Original languageEnglish
Pages (from-to)958-964
Number of pages7
JournalDigestive and Liver Disease
Volume43
Issue number12
DOIs
Publication statusPublished - 2011 Dec 1

Fingerprint

Neoplasms
Pyloric Stenosis
Duodenum
Stomach
Endoscopic Mucosal Resection
Margins of Excision

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

Cite this

Park, Jun Chul ; Kim, Jie Hyun ; Youn, Young Hoon ; Cheoi, Kyungseok ; Chung, Hyunsoo ; Kim, Hyunki ; Lee, Hyuk ; Shin, Sung Kwan ; Lee, Sang Kil ; Kim, Hoguen ; Park, Hyojin ; Lee, Sang In ; Lee, Yong Chan. / How to manage pyloric tumours that are difficult to resect completely with endoscopic resection : Comparison of the retroflexion vs. forward view technique. In: Digestive and Liver Disease. 2011 ; Vol. 43, No. 12. pp. 958-964.
@article{2f1b4982bf4542208d92a3deb42595a7,
title = "How to manage pyloric tumours that are difficult to resect completely with endoscopic resection: Comparison of the retroflexion vs. forward view technique",
abstract = "Background: It is difficult to perform complete resection of prepyloric tumours, especially those involving pyloric channel due to incomplete visualisation and insufficient resection margin with forward view. Aim: To investigate outcomes of endoscopic submucosal dissection for pyloric tumours, we assess effectiveness of retroflexion view technique in comparison with forward view technique. Methods: We investigated 47 prepyloric tumours treated by endoscopic submucosal dissection and compared results of forward view technique with those of retroflexion view technique. Results: Of the 47 prepyloric tumours, 23 lesions had pyloric channel involvement (group 1) and 24 lesions did not (group 2). The en bloc resection, curative resection and complete resection rates for all endoscopic submucosal dissection cases were 80.9, 85.1 and 70.2{\%}, respectively. The en bloc resection, curative resection and complete resection rates were significantly lower in group 1 than group 2. Of the tumours involving pyloric channel except 3 cases which were extended to duodenum, 12 lesions were resected with retroflexion and 8 lesions with forward. Curative resection rate was higher in retroflexion group than forward group (91.7{\%} vs. 37.5{\%}; p= 0.018). None of the patients experienced perforation or pyloric stenosis. Conclusions: Endoscopic submucosal dissection using retroflexion manoeuvre is a more effective method for the curative resection of gastric tumours involving pyloric channel.",
author = "Park, {Jun Chul} and Kim, {Jie Hyun} and Youn, {Young Hoon} and Kyungseok Cheoi and Hyunsoo Chung and Hyunki Kim and Hyuk Lee and Shin, {Sung Kwan} and Lee, {Sang Kil} and Hoguen Kim and Hyojin Park and Lee, {Sang In} and Lee, {Yong Chan}",
year = "2011",
month = "12",
day = "1",
doi = "10.1016/j.dld.2011.08.008",
language = "English",
volume = "43",
pages = "958--964",
journal = "Digestive and Liver Disease",
issn = "1590-8658",
publisher = "Elsevier",
number = "12",

}

How to manage pyloric tumours that are difficult to resect completely with endoscopic resection : Comparison of the retroflexion vs. forward view technique. / Park, Jun Chul; Kim, Jie Hyun; Youn, Young Hoon; Cheoi, Kyungseok; Chung, Hyunsoo; Kim, Hyunki; Lee, Hyuk; Shin, Sung Kwan; Lee, Sang Kil; Kim, Hoguen; Park, Hyojin; Lee, Sang In; Lee, Yong Chan.

In: Digestive and Liver Disease, Vol. 43, No. 12, 01.12.2011, p. 958-964.

Research output: Contribution to journalArticle

TY - JOUR

T1 - How to manage pyloric tumours that are difficult to resect completely with endoscopic resection

T2 - Comparison of the retroflexion vs. forward view technique

AU - Park, Jun Chul

AU - Kim, Jie Hyun

AU - Youn, Young Hoon

AU - Cheoi, Kyungseok

AU - Chung, Hyunsoo

AU - Kim, Hyunki

AU - Lee, Hyuk

AU - Shin, Sung Kwan

AU - Lee, Sang Kil

AU - Kim, Hoguen

AU - Park, Hyojin

AU - Lee, Sang In

AU - Lee, Yong Chan

PY - 2011/12/1

Y1 - 2011/12/1

N2 - Background: It is difficult to perform complete resection of prepyloric tumours, especially those involving pyloric channel due to incomplete visualisation and insufficient resection margin with forward view. Aim: To investigate outcomes of endoscopic submucosal dissection for pyloric tumours, we assess effectiveness of retroflexion view technique in comparison with forward view technique. Methods: We investigated 47 prepyloric tumours treated by endoscopic submucosal dissection and compared results of forward view technique with those of retroflexion view technique. Results: Of the 47 prepyloric tumours, 23 lesions had pyloric channel involvement (group 1) and 24 lesions did not (group 2). The en bloc resection, curative resection and complete resection rates for all endoscopic submucosal dissection cases were 80.9, 85.1 and 70.2%, respectively. The en bloc resection, curative resection and complete resection rates were significantly lower in group 1 than group 2. Of the tumours involving pyloric channel except 3 cases which were extended to duodenum, 12 lesions were resected with retroflexion and 8 lesions with forward. Curative resection rate was higher in retroflexion group than forward group (91.7% vs. 37.5%; p= 0.018). None of the patients experienced perforation or pyloric stenosis. Conclusions: Endoscopic submucosal dissection using retroflexion manoeuvre is a more effective method for the curative resection of gastric tumours involving pyloric channel.

AB - Background: It is difficult to perform complete resection of prepyloric tumours, especially those involving pyloric channel due to incomplete visualisation and insufficient resection margin with forward view. Aim: To investigate outcomes of endoscopic submucosal dissection for pyloric tumours, we assess effectiveness of retroflexion view technique in comparison with forward view technique. Methods: We investigated 47 prepyloric tumours treated by endoscopic submucosal dissection and compared results of forward view technique with those of retroflexion view technique. Results: Of the 47 prepyloric tumours, 23 lesions had pyloric channel involvement (group 1) and 24 lesions did not (group 2). The en bloc resection, curative resection and complete resection rates for all endoscopic submucosal dissection cases were 80.9, 85.1 and 70.2%, respectively. The en bloc resection, curative resection and complete resection rates were significantly lower in group 1 than group 2. Of the tumours involving pyloric channel except 3 cases which were extended to duodenum, 12 lesions were resected with retroflexion and 8 lesions with forward. Curative resection rate was higher in retroflexion group than forward group (91.7% vs. 37.5%; p= 0.018). None of the patients experienced perforation or pyloric stenosis. Conclusions: Endoscopic submucosal dissection using retroflexion manoeuvre is a more effective method for the curative resection of gastric tumours involving pyloric channel.

UR - http://www.scopus.com/inward/record.url?scp=80055096003&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80055096003&partnerID=8YFLogxK

U2 - 10.1016/j.dld.2011.08.008

DO - 10.1016/j.dld.2011.08.008

M3 - Article

C2 - 21920829

AN - SCOPUS:80055096003

VL - 43

SP - 958

EP - 964

JO - Digestive and Liver Disease

JF - Digestive and Liver Disease

SN - 1590-8658

IS - 12

ER -