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Clinical outcomes of endoscopic submucosal dissection (ESD) for treating early gastric cancer: comparison with endoscopic mucosal resection after circumferential precutting (EMR-P).
Dig Liver Dis 2009; 41(3):201-9DL

Abstract

BACKGROUND

To achieve en bloc resection for large lesions, endoscopic mucosal resection after circumferential precutting and endoscopic submucosal dissection techniques have been developed.

AIM

To compare endoscopic submucosal dissection with endoscopic mucosal resection after circumferential precutting in terms of the clinical efficacy and safety.

PATIENTS AND METHODS

346 consecutive patients underwent their first endoscopic mucosal resection after circumferential precutting (103 patients) or endoscopic submucosal dissection (243 patients) for early gastric cancer and their clinical outcomes were compared.

RESULTS

For early gastric cancer >or=20mm endoscopic submucosal dissection group demonstrated significantly higher en bloc resection and en bloc plus R0 resection rate compared with endoscopic mucosal resection after circumferential precutting group. For early gastric cancer with size of 10-19 mm, endoscopic submucosal dissection group also showed significantly higher en bloc resection rate. For early gastric cancer <20mm, however, en bloc plus R0 resection rate for endoscopic mucosal resection after circumferential precutting group was comparable to that for endoscopic submucosal dissection group. In case of R0 resection of intramucosal differentiated cancer, neither group showed local recurrence during the median 29 and 17 months of follow-up. Two groups did not show significant difference in the bleeding or perforation rates.

CONCLUSION

For early gastric cancer <20mm endoscopic mucosal resection after circumferential precutting may be considered as an alternative choice to endoscopic submucosal dissection. However, for early gastric cancer >or=20mm endoscopic submucosal dissection should be considered as the first choice for treating early gastric cancer.

Authors+Show Affiliations

Department of Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center, Gangnam-gu, Seoul, Republic of Korea.No affiliation info availableNo 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)

Comparative Study
Journal Article

Language

eng

PubMed ID

18571998

Citation

Min, B-H, et al. "Clinical Outcomes of Endoscopic Submucosal Dissection (ESD) for Treating Early Gastric Cancer: Comparison With Endoscopic Mucosal Resection After Circumferential Precutting (EMR-P)." Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, vol. 41, no. 3, 2009, pp. 201-9.
Min BH, Lee JH, Kim JJ, et al. Clinical outcomes of endoscopic submucosal dissection (ESD) for treating early gastric cancer: comparison with endoscopic mucosal resection after circumferential precutting (EMR-P). Dig Liver Dis. 2009;41(3):201-9.
Min, B. H., Lee, J. H., Kim, J. J., Shim, S. G., Chang, D. K., Kim, Y. H., ... Rhee, J. C. (2009). Clinical outcomes of endoscopic submucosal dissection (ESD) for treating early gastric cancer: comparison with endoscopic mucosal resection after circumferential precutting (EMR-P). Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, 41(3), pp. 201-9. doi:10.1016/j.dld.2008.05.006.
Min BH, et al. Clinical Outcomes of Endoscopic Submucosal Dissection (ESD) for Treating Early Gastric Cancer: Comparison With Endoscopic Mucosal Resection After Circumferential Precutting (EMR-P). Dig Liver Dis. 2009;41(3):201-9. PubMed PMID: 18571998.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical outcomes of endoscopic submucosal dissection (ESD) for treating early gastric cancer: comparison with endoscopic mucosal resection after circumferential precutting (EMR-P). AU - Min,B-H, AU - Lee,J H, AU - Kim,J J, AU - Shim,S G, AU - Chang,D K, AU - Kim,Y-H, AU - Rhee,P-L, AU - Kim,K-M, AU - Park,C K, AU - Rhee,J C, Y1 - 2008/06/20/ PY - 2008/01/22/received PY - 2008/04/26/revised PY - 2008/05/08/accepted PY - 2008/6/24/pubmed PY - 2009/5/29/medline PY - 2008/6/24/entrez SP - 201 EP - 9 JF - Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver JO - Dig Liver Dis VL - 41 IS - 3 N2 - BACKGROUND: To achieve en bloc resection for large lesions, endoscopic mucosal resection after circumferential precutting and endoscopic submucosal dissection techniques have been developed. AIM: To compare endoscopic submucosal dissection with endoscopic mucosal resection after circumferential precutting in terms of the clinical efficacy and safety. PATIENTS AND METHODS: 346 consecutive patients underwent their first endoscopic mucosal resection after circumferential precutting (103 patients) or endoscopic submucosal dissection (243 patients) for early gastric cancer and their clinical outcomes were compared. RESULTS: For early gastric cancer >or=20mm endoscopic submucosal dissection group demonstrated significantly higher en bloc resection and en bloc plus R0 resection rate compared with endoscopic mucosal resection after circumferential precutting group. For early gastric cancer with size of 10-19 mm, endoscopic submucosal dissection group also showed significantly higher en bloc resection rate. For early gastric cancer <20mm, however, en bloc plus R0 resection rate for endoscopic mucosal resection after circumferential precutting group was comparable to that for endoscopic submucosal dissection group. In case of R0 resection of intramucosal differentiated cancer, neither group showed local recurrence during the median 29 and 17 months of follow-up. Two groups did not show significant difference in the bleeding or perforation rates. CONCLUSION: For early gastric cancer <20mm endoscopic mucosal resection after circumferential precutting may be considered as an alternative choice to endoscopic submucosal dissection. However, for early gastric cancer >or=20mm endoscopic submucosal dissection should be considered as the first choice for treating early gastric cancer. SN - 1878-3562 UR - https://www.unboundmedicine.com/medline/citation/18571998/Clinical_outcomes_of_endoscopic_submucosal_dissection__ESD__for_treating_early_gastric_cancer:_comparison_with_endoscopic_mucosal_resection_after_circumferential_precutting__EMR_P__ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1590-8658(08)00204-1 DB - PRIME DP - Unbound Medicine ER -