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Key factors for successful en bloc endoscopic submucosal dissection of early stage gastric cancer using an insulation-tipped diathermic knife.
Hepatogastroenterology 2006 Jul-Aug; 53(70):639-42H

Abstract

BACKGROUND/AIMS

En bloc endoscopic mucosal resection (EMR) is presently considered to be the treatment of choice for endoscopically resectable early stage gastric cancer (EGC). Although a new EMR technique using an insulation-tipped diathermic knife (endoscopic submucosal dissection using an IT knife: IT knife-ESD) is reportedly suitable for en bloc resection, a failure in en bloc resection (piecemeal resection) can occur. We retrospectively analyzed factors affecting the success rate of en bloc resection by IT knife-ESD.

METHODOLOGY

A total of 71 gastric lesions were treated by IT knife-ESD. En bloc/piecemeal resection rates were investigated. Twelve potential factors associated with clinicopathological characteristics or procedures were analyzed univariately and multivariately.

RESULTS

IT knife-ESD was successfully performed in all 71 lesions. En bloc resection was achieved in 63 lesions (91%), while eight lesions (9%) were removed as two or more fragments (piecemeal resection). The multivariate analysis identified only one independent factor affecting the success rate of en bloc resection: the second-half period of procedure application. The en bloc resection rate was not associated with the tumor location/site, tumor size, specimen size, and ulceration within the tumor.

CONCLUSIONS

Much experience with IT knife-ESD may resolve the tumor-related technical difficulties. It is true for this advanced procedure that endoscopist experience is highly likely to be a critical factor for treatment success. We consider that IT knife-ESD for EGC is feasible and safe when performed by experienced endoscopists.

Authors+Show Affiliations

Department of Surgery, Kyorin University School of Medicine, Tokyo, Japan. abenbtg@kyorin-u.ac.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

16995479

Citation

Abe, Nobutsugu, et al. "Key Factors for Successful En Bloc Endoscopic Submucosal Dissection of Early Stage Gastric Cancer Using an Insulation-tipped Diathermic Knife." Hepato-gastroenterology, vol. 53, no. 70, 2006, pp. 639-42.
Abe N, Yamaguchi Y, Takeuchi H, et al. Key factors for successful en bloc endoscopic submucosal dissection of early stage gastric cancer using an insulation-tipped diathermic knife. Hepatogastroenterology. 2006;53(70):639-42.
Abe, N., Yamaguchi, Y., Takeuchi, H., Izumisato, Y., Yanagida, O., Masaki, T., ... Atomi, Y. (2006). Key factors for successful en bloc endoscopic submucosal dissection of early stage gastric cancer using an insulation-tipped diathermic knife. Hepato-gastroenterology, 53(70), pp. 639-42.
Abe N, et al. Key Factors for Successful En Bloc Endoscopic Submucosal Dissection of Early Stage Gastric Cancer Using an Insulation-tipped Diathermic Knife. Hepatogastroenterology. 2006;53(70):639-42. PubMed PMID: 16995479.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Key factors for successful en bloc endoscopic submucosal dissection of early stage gastric cancer using an insulation-tipped diathermic knife. AU - Abe,Nobutsugu, AU - Yamaguchi,Yasuharu, AU - Takeuchi,Hirohisa, AU - Izumisato,Yumi, AU - Yanagida,Osamu, AU - Masaki,Tadahiko, AU - Mori,Toshiyuki, AU - Sugiyama,Masanori, AU - Atomi,Yutaka, PY - 2006/9/26/pubmed PY - 2006/12/22/medline PY - 2006/9/26/entrez SP - 639 EP - 42 JF - Hepato-gastroenterology JO - Hepatogastroenterology VL - 53 IS - 70 N2 - BACKGROUND/AIMS: En bloc endoscopic mucosal resection (EMR) is presently considered to be the treatment of choice for endoscopically resectable early stage gastric cancer (EGC). Although a new EMR technique using an insulation-tipped diathermic knife (endoscopic submucosal dissection using an IT knife: IT knife-ESD) is reportedly suitable for en bloc resection, a failure in en bloc resection (piecemeal resection) can occur. We retrospectively analyzed factors affecting the success rate of en bloc resection by IT knife-ESD. METHODOLOGY: A total of 71 gastric lesions were treated by IT knife-ESD. En bloc/piecemeal resection rates were investigated. Twelve potential factors associated with clinicopathological characteristics or procedures were analyzed univariately and multivariately. RESULTS: IT knife-ESD was successfully performed in all 71 lesions. En bloc resection was achieved in 63 lesions (91%), while eight lesions (9%) were removed as two or more fragments (piecemeal resection). The multivariate analysis identified only one independent factor affecting the success rate of en bloc resection: the second-half period of procedure application. The en bloc resection rate was not associated with the tumor location/site, tumor size, specimen size, and ulceration within the tumor. CONCLUSIONS: Much experience with IT knife-ESD may resolve the tumor-related technical difficulties. It is true for this advanced procedure that endoscopist experience is highly likely to be a critical factor for treatment success. We consider that IT knife-ESD for EGC is feasible and safe when performed by experienced endoscopists. SN - 0172-6390 UR - https://www.unboundmedicine.com/medline/citation/16995479/Key_factors_for_successful_en_bloc_endoscopic_submucosal_dissection_of_early_stage_gastric_cancer_using_an_insulation_tipped_diathermic_knife_ L2 - https://medlineplus.gov/stomachcancer.html DB - PRIME DP - Unbound Medicine ER -