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

Dong Hoo Joh, Chan Hyuk Park, Sungmo Jung, Seung Ho Choi, Hyun Ki Kim, Hyuk Lee, Jun Chul Park, Sung Kwan Shin, Yong Chan Lee, Sang Kil Lee

Research output: Contribution to journalArticle

4 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)3690-3697
Number of pages8
JournalSurgical endoscopy
Volume29
Issue number12
DOIs
Publication statusPublished - 2015 Dec 1

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Stomach
Safety
Stomach Neoplasms
Neoplasms
Multiple Primary Neoplasms
Recurrence
Adenoma
Aspiration Pneumonia
Endoscopic Mucosal Resection
Hemorrhage

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Joh, Dong Hoo ; Park, Chan Hyuk ; Jung, Sungmo ; Choi, Seung Ho ; Kim, Hyun Ki ; Lee, Hyuk ; Park, Jun Chul ; Shin, Sung Kwan ; Lee, Yong Chan ; Lee, Sang Kil. / Safety and feasibility of simultaneous endoscopic submucosal dissection for multiple gastric neoplasias. In: Surgical endoscopy. 2015 ; Vol. 29, No. 12. pp. 3690-3697.
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Safety and feasibility of simultaneous endoscopic submucosal dissection for multiple gastric neoplasias. / Joh, Dong Hoo; Park, Chan Hyuk; Jung, Sungmo; Choi, Seung Ho; Kim, Hyun Ki; Lee, Hyuk; Park, Jun Chul; Shin, Sung Kwan; Lee, Yong Chan; Lee, Sang Kil.

In: Surgical endoscopy, Vol. 29, No. 12, 01.12.2015, p. 3690-3697.

Research output: Contribution to journalArticle

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AU - Park, Chan Hyuk

AU - Jung, Sungmo

AU - Choi, Seung Ho

AU - Kim, Hyun Ki

AU - Lee, Hyuk

AU - Park, Jun Chul

AU - Shin, Sung Kwan

AU - Lee, Yong Chan

AU - Lee, Sang Kil

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N2 - 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.

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