Sa1638 Risk Factors for Local Recurrence After En Bloc Resection of Endoscopic Submucosal Dissection for the Early Gastric Cancer Treatment

2011 ◽  
Vol 73 (4) ◽  
pp. AB231
Author(s):  
Eunsoo Kim ◽  
Kwangbum Cho ◽  
Kyung Sik Park
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Local Recurrence ◽  
Endoscopic Submucosal Dissection ◽  
Cancer Treatment ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
Gastric Cancer Treatment

scholarly journals Endoscopic submucosal dissection versus endoscopic mucosal resection for patients with early gastric cancer: a meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e025803 ◽  
Author(s):  
Maogen Tao ◽  
Xiaobo Zhou ◽  
Meiqing Hu ◽  
Jun Pan
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Local Recurrence ◽  
Curative Resection ◽  
Meta Analysis ◽  
Operation Time ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Complete Resection ◽  
En Bloc

ObjectivesTo investigate the treatment effects of endoscopic submucosal dissection (ESD) versus endoscopic mucosal resection (EMR) for early gastric cancer (EGC).DesignMeta-analysis.MethodsWe systematically searched three electronic databases, including PubMed, EmBase and the Cochrane library for studies published with inception to January 2018. The eligible studies should be evaluated for the efficacy and safety of ESD versus EMR for patients with EGC. The summary ORs and standard mean differences (SMDs) with 95% CIs were employed as effect estimates. Sensitivity analyses were conducted to evaluate the impact of single study on overall analysis. Subgroup analyses were performed for investigated outcomes to evaluate the treatment effects of ESD versus EMR for patients with EGC with specific subsets.ResultsEighteen studies, with a total of 6723 patients with EGC, were included in final analysis. The summary ORs indicated that patients with EGC who received ESD were associated with an increased incidence of en bloc resection (OR: 9.00; 95% CI: 6.66 to 12.17; p<0.001), complete resection (OR: 8.43; 95% CI: 5.04 to 14.09; p<0.001) and curative resection (OR: 2.92; 95% CI: 1.85 to 4.61; p<0.001) when compared with EMR. Furthermore, ESD was associated with lower risk of local recurrence (OR: 0.18; 95% CI: 0.09 to 0.34; p<0.001). In addition, there was no significant difference between ESD and EMR for the risk of bleeding (OR: 1.26; 95% CI: 0.88 to 1.80; p=0.203). Though, ESD was correlated with greater risk of perforation (OR: 2.55; 95% CI: 1.48 to 4.39; p=0.001), and longer operation time (SMD: 1.12; 95% CI: 0.13 to 2.10; p=0.026) as compared with EMR. Additionally, several different features observed in included studies and patients could bias the effectiveness of ESD versus EMR in patients with EGC.ConclusionsESD is superior than EMR for en bloc resection, complete resection, curative resection and local recurrence, while it increased perforation risk and longer operation time.

scholarly journals Risk factors for local recurrence after en bloc endoscopic submucosal dissection for early gastric cancer

2016 ◽  
Vol 8 (7) ◽  
pp. 330 ◽  
Author(s):  
Ju Yup Lee ◽  
Kwang Bum Cho ◽  
Eun Soo Kim ◽  
Kyung Sik Park ◽  
Yoo Jin Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Local Recurrence ◽  
Endoscopic Submucosal Dissection ◽  
En Bloc ◽  
Submucosal Dissection

scholarly journals Risk Factors for Technical Difficulty of Endoscopic Submucosal Dissection in Colorectal Tumors: A Case Series and Meta-Analysis

2020 ◽  
Author(s):  
Yan Gao ◽  
Wei Jiang ◽  
Hui-Hong Zhai ◽  
Jianing Xu ◽  
Shanshan Wu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Endoscopic Submucosal Dissection ◽  
Meta Analysis ◽  
Dentate Line ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
Submucosal Dissection ◽  
Submucosal Fibrosis ◽  
Lifting Sign

Abstract Background and Aims: Endoscopic submucosal dissection has become widely accepted as an efficient and well-established option for colorectal neoplastic lesions (CRNs). However, there are still some barriers for endoscopists that hinder the successful ESD. The current study was to evaluate risk factors for the failure of en-bloc resection in the colorectal endoscopic submucosal dissection (ESD).Methods: A retrospective chart review was performed from patients who underwent ESD for colorectal neoplasms (CRNs) between January 2015 and April 2017. The demographics and colonoscopic reports were analyzed. A meta-analysis was conducted for the risk factors for the failure of en-bloc or R0 resection. Results: 253 ESD cases were completed in en-bloc resection. Ulcerative colitis, previous abdominal surgeries, lesions on the Bauhin’s valve/ dentate line, non-lifting sign and submucosal fibrosis were associated with the failure of en-bloc resection (P<0.05). Meta-analysis showed that laterally spreading tumors, tumor larger than 40mm, Bauhin’s valve/dentate line, flexure, non-lifting sign, and submucosal fibrosis were the factors for the failure of en bloc or R0 resection. The rates of perforation were obviously higher in N-EBR groups compared to EBR groups. No significant results can be observed on the local recurrence based on these studies. Conclusions: Preoperative factors such as laterally spreading tumors, tumor larger than 40mm, Bauhin’s valve/dentate line, flexure and intraoperative factors such as non-lifting sign, submucosal fibrosis should be put more focus to reach better outcomes in CRNs patients.

scholarly journals Local Recurrence After Endoscopic Submucosal Dissection of Early Gastric Cancer

2022 ◽  
Author(s):  
Cheol Woong Choi ◽  
Su Jin Kim ◽  
Dae Gon Ryu ◽  
Dae Hwan Kang ◽  
Hyung Wook Kim ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Local Recurrence ◽  
Endoscopic Submucosal Dissection ◽  
Lesion Size ◽  
Tertiary Referral Hospital ◽  
En Bloc ◽  
Factors Associated ◽  
Submucosal Dissection ◽  
Undifferentiated Adenocarcinoma

Abstract Background: Endoscopic submucosal dissection (ESD) is considered the treatment of choice for early gastric cancer (EGC) with a negligible risk of lymph node metastasis. However, locally recurrent lesions on artificial ulcer scars are difficult to manage. Therefore, predicting the risk of local recurrence after ESD is important to manage and prevent the event. This study aimed to elucidate risk factors associated with local recurrence after ESD of EGC.Methods: Between November 2008 and February 2016, consecutive patients (n=641; mean age, 69.3±9.5 years; men, 77.2%) with EGC who underwent ESD at a single tertiary referral hospital were retrospectively analyzed to evaluate the incidence and factors associated with local recurrence. Local recurrence was defined as the development of neoplastic lesions at or adjacent to the site of the post-ESD scar.Results: En bloc and complete resection rates were 97.8% and 93.6%, respectively. The local recurrence rate after ESD was 3.1%. The mean follow-up period after ESD was 50.7±32.5 months. One case of gastric cancer-related death (0.15%) was noted, wherein the patient had refused additive surgical resection after ESD for EGC with lymphatic and deep submucosal invasion. Lesion size ≥15 mm, incomplete histologic resection, undifferentiated adenocarcinoma, scar, and absence of erythema of the surface were associated with a higher risk of local recurrence. Conclusions: Predicting local recurrence during regular endoscopic surveillance after ESD is important, especially in patients with a larger lesion size (≥15 mm), incomplete histologic resection, surface changes of scars, and no erythema of the surface.

scholarly journals P-O07 Endoscopic submucosal dissection for giant esophageal lipomatous tumors

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Zi-Han Geng ◽  
Xiao-Yue Xu ◽  
Yan Yan Zhu ◽  
Wei Su ◽  
Quan-Lin Li ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Endoscopic Submucosal Dissection ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Maximum Diameter ◽  
En Bloc ◽  
Submucosal Dissection ◽  
Gastric Submucosal Tumors ◽  
Average Maximum ◽  
Lipomatous Tumors

Abstract Background Thoracotomy is the foremost choice of giant esophageal lipomatous tumors in previous studies, but it is highly traumatic and possibly diminishes the quality of patients’ life. To minimize such impacts, a minimally invasive method without loss of curability is desirable for giant lipomatous tumors of the esophagus. With recent progress in endoscopic techniques and devices, endoscopic submucosal dissection (ESD) has been successfully used to remove esophageal or gastric submucosal tumors (SMTs). Methods Objective: To evaluate the clinical impact of ESD for giant esophageal lipomatous tumors.  Design: Single-center, retrospective study. Setting: Academic medical center. Patients: Six patients with six giant lipomatous tumors of the esophagus between February 2013 and December 2020. Interventions: ESD. Main Outcome Measurements: Procedure duration, en bloc resection rate, complications, local recurrence, and distant metastases. Results Endoscopic en bloc resections of esophageal lipomatous tumors were successfully performed in all patients, with a mean duration of 56.5 ± 26.0 min. All en bloc resection lesions showed both lateral and deep tumor-free margins. The average maximum diameter of the esophageal lipomatous tumors was 171.7 ± 66.2 mm. No complications such as bleeding and perforations happened during hospitalization with 4.0 ± 1.6 days. Besides, local recurrence and distant metastasis have not occurred during the follow-up period. Conclusions ESD was a safe and effective way to dissect giant lipomatous tumors of the esophagus thoroughly. 

scholarly journals Risk Factors for Local Recurrence of Early Gastric Cancer after Endoscopic Submucosal Dissection

2013 ◽  
Vol 85 (3) ◽  
pp. 285 ◽  
Author(s):  
Jung Ho Kim ◽  
Jung Hyun Lee ◽  
Jun-Won Chung ◽  
Jungsuk An ◽  
In Sik Won ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Local Recurrence ◽  
Endoscopic Submucosal Dissection ◽  
Submucosal Dissection

scholarly journals Risk factors and management of positive horizontal margin in early gastric cancer resected by en bloc endoscopic submucosal dissection

2014 ◽  
Vol 18 (2) ◽  
pp. 332-338 ◽  
Author(s):  
Norifumi Numata ◽  
Shiro Oka ◽  
Shinji Tanaka ◽  
Kenichi Kagemoto ◽  
Yoji Sanomura ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Endoscopic Submucosal Dissection ◽  
En Bloc ◽  
Submucosal Dissection ◽  
Horizontal Margin

Risk factors for conversion to snare resection during colorectal endoscopic submucosal dissection in an expert Western center

Endoscopy ◽  
2018 ◽  
Vol 51 (02) ◽  
pp. 152-160 ◽  
Author(s):  
Enrique Pérez-Cuadrado-Robles ◽  
Christophe Snauwaert ◽  
Tom Moreels ◽  
Anne Jouret-Mourin ◽  
Pierre Deprez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Endoscopic Submucosal Dissection ◽  
Tumor Size ◽  
Multivariable Analysis ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
Factors Associated ◽  
Submucosal Dissection ◽  
Colorectal Endoscopic Submucosal Dissection

Abstract Background There are limited data regarding the risk factors and consequences of conversion to endoscopic mucosal resection (rescue EMR) during colorectal endoscopic submucosal dissection (ESD) in Western centers. Methods This was a retrospective analysis of a prospectively collected database, from which 225 consecutive ESDs performed between 2013 and 2017 were selected. Of the included patients, 39 (18.6 %) required rescue EMR. Pre- and per-procedure characteristics were evaluated to determine the features associated with the need for rescue EMR. Outcomes and complications were also assessed. Results 210 patients were included, with median tumor size of 40 mm (range 20 – 110) and most tumors being in a non-rectal location (66.2 %). When compared with full ESD, rescue EMR was significantly associated with lower rates of en bloc resection (43.6 % vs. 100 %) and complete resection (R0 status; 28.2 % vs. 88.9 %), and with a higher rate of recurrence (5.1 % vs. 0 %) and more need for surgery (15.4 % vs. 3.5 %). In multivariable analysis, non-lifting (adjusted odds ratio [ORa] 3.06, 95 % confidence interval [CI] 1.23 – 7.66; P = 0.02), nongranular-type laterally spreading tumor (LST-NG; ORa 2.56, 95 %CI 1.10 – 5.99; P = 0.03), and difficult retroflexion (OR 3.22, 95 %CI 1.01 – 10.28; P = 0.049) were independent risk factors associated with conversion to rescue EMR, while tumor size and location were not. Conclusions During ESD, the presence of poor lifting, LST-NG morphology, and a difficult retroflexed approach were factors associated with the need to convert to rescue EMR. Conversion to rescue EMR remains a valuable strategy.

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