scholarly journals The Comparison between Endoscopic Submucosal Dissection and Surgery in Gastric Cancer: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Junbi Hu ◽  
Yan Zhao ◽  
Mudan Ren ◽  
Yarui Li ◽  
Xinlan Lu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Endoscopic Submucosal Dissection ◽  
Hospital Stay ◽  
Meta Analysis ◽  
Treatment Modalities ◽  
Adverse Event Rate ◽  
Submucosal Dissection ◽  
Surgery Group ◽  
The Difference

Aims. There are two treatment modalities for early gastric cancer (EGC)—surgery and endoscopic submucosal dissection (ESD). We aimed to compare the safety and efficacy of ESD with surgery. Method. The article was performed by searching PubMed databases. Data were extracted using predefined form and odds ratios (OR) with 95% confidence intervals (CI) calculated and P value. Results. 13 studies were identified. The incidence of perforation in two groups was different [OR = 6.18 (95% CI: 1.37–27.98), P=0.02]. The prevalences of synchronous and metachronous cancer in the ESD group were higher than those in the surgery group [OR = 8.52 (95% CI: 1.99–36.56), P = 0.004 and OR = 7.15 (95% CI: 2.95–17.32), P<0.0001]. The recurrence and complete resection rates were different [OR = 6.93 (95% CI: 2.83–16.96), P<0.0001 and OR = 0.32 (95% CI: 0.20–0.52), P<0.00001]. Compared with the surgery group, the hospital stay was shorter [IV = −7.15 (95% CI: −9.08–5.22), P<0.00001], the adverse event rate was lower, and the quality of life (QOL) was better in the ESD group. The difference of bleeding was not found. Conclusion. ESD appears to be preferable for EGC, due to a lower rate of adverse events, shorter hospital stay, cheaper cost, and higher QOL.

scholarly journals Early vs. Delayed Feeding after Endoscopic Submucosal Dissection for Gastric Cancer: A Systematic Review and Meta-Analysis

Medicina ◽  
2020 ◽  
Vol 56 (12) ◽  
pp. 653
Author(s):  
Jun Watanabe ◽  
Joji Watanabe ◽  
Kazuhiko Kotani
Keyword(s):  
Gastric Cancer ◽  
Quality Of Care ◽  
Endoscopic Submucosal Dissection ◽  
Hospital Stay ◽  
World Health ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Patients Satisfaction ◽  
Submucosal Dissection

Background: Endoscopic submucosal dissection (ESD) for gastric cancer is increasingly performed worldwide due to its efficacy and safety. This study aimed to assess the evidence of the impact of early vs. delayed feeding after ESD on quality of care, which remains to be fully determined. Methods: Electronic databases (PubMed, the Cochrane Central Register of Controlled Trials, EMBASE) and the trial registries (the World Health Organization International Clinical Trials Platform Search Portal and ClinicalTrials.gov) were searched for studies performed prior to September 2020. Study selection, data abstraction, and quality assessment were independently performed using the Grading of Recommendations Assessment, Development, and Evaluation approach. Self-rated satisfaction and hospital stay were chiefly analyzed. Results: Two randomized controlled trials (239 patients) were included. The early and delayed post-ESD feeding groups had similar rates of post-ESD bleeding (risk ratio 1.90, 95% CI 0.42 to 8.63; I2 = 0%). Early post-ESD feeding resulted in increased patients’ satisfaction in comparison to delayed post-ESD feeding (standard mean difference (MD) 0.54, 95% CI 0.27 to 0.81; I2 = 0%) and reduced the length of hospital stay (MD −0.83, 95% CI −1.01 to −0.65; I2 = 0%). Conclusion: Early post-ESD feeding was associated with increased patients’ satisfaction and reduced hospital stay in comparison to delayed feeding, while the rate of complications did not differ to a statistically significant extent. As we must acknowledge the limited number of reviewed studies, various trials regarding the quality of care are further needed to determine the benefits of early feeding after ESD.

scholarly journals 870 The Efficacy and Safety of Endoscopic Submucosal Dissection for Early Gastric Cancer in Patients With Cirrhosis: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 114 (1) ◽  
pp. S504-S505
Author(s):  
Passisd Laoveeravat ◽  
Abhilash Perisetti ◽  
Wasawat Vutthikraivit ◽  
Mauricio Garcia-Saenz-de-Sicilia ◽  
Shashank Garg ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Systematic Review ◽  
Early Gastric Cancer ◽  
Endoscopic Submucosal Dissection ◽  
Meta Analysis ◽  
Efficacy And Safety ◽  
Submucosal Dissection

scholarly journals Preprocedural prediction of non-curative endoscopic submucosal dissection for early gastric cancer.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 74-74
Author(s):  
Cheol Woong Choi ◽  
Dae Hwan Kang ◽  
Su Jin Kim
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Endoscopic Submucosal Dissection ◽  
Endoscopic Resection ◽  
Predictive Factors ◽  
Lesion Size ◽  
Treatment Modalities ◽  
Resection Margins ◽  
Tertiary Referral Hospital ◽  
Submucosal Dissection

74 Background: Endoscopic submucosal dissection (ESD) has been accepted as the treatment of choice for early gastric cancer (EGC) without lymph node metastasis. However, additional surgical gastrectomy should be considered after non-curative endoscopic resection. We aimed to evaluate the predictive factors associated with non-curative endoscopic resection. Methods: Between November 2008 and June 2015, a retrospective study was conducted in a single, tertiary, referral hospital. A total of 596 EGC lesions resected by ESD were analyzed. Non-curative endoscopic resection was defined as the occurrence of lesions associated with piecemeal resection, positive resection margins, lymphovascular invasion, or lesions that did not meet the expanded indications for ESD. Results: The rate of non-curative endoscopic resection was 16.1%. The mean follow-up period was 35.3 ± 25.0 months. Associated predictive factors for non-curative endoscopic resection were female sex (OR, 2.470; p = 0.004), lesion size ≥ 20 mm (OR 3.714; p < 0.001), longer procedure time (OR 2.449, p = 0.002), ulceration (OR 3.538, p = 0.002), nodularity (OR 2.967, p < 0.001), depression (OR 1.806, p = 0.038), undifferentiated carcinoma (OR 2.825, p = 0.031) and lesion located in the mid or upper third of stomach (OR 7.135 and OR 4.155, p < 0.001, respectively). As the number of risk factors increased, the risk of non-curative ESD also increased. Conclusions: Prior to selection of ESD, the risks associated with non-curative ESD should be considered so that appropriate treatment modalities may be selected.

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