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World J Gastroenterol. 2018 Sep 7;24(33):3776-3785. doi: 10.3748/wjg.v24.i33.3776.

Secondary endoscopic submucosal dissection for locally recurrent or incompletely resected gastric neoplasms.

Author information

1
Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, South Korea.
2
Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, South Korea. dryoun@yuhs.ac.

Abstract

AIM:

To investigate the feasibility and safety of secondary endoscopic submucosal dissection (ESD) for residual or locally recurrent gastric tumors.

METHODS:

Between 2010 and 2017, 1623 consecutive patients underwent ESD for gastric neoplasms at a single tertiary referral center. Among these, 28 patients underwent secondary ESD for a residual or locally recurrent tumor. Our analysis compared clinicopathologic factors between primary ESD and secondary ESD groups.

RESULTS:

The en bloc resection and curative rate of resection of secondary ESD were 92.9% and 89.3%, respectively. The average procedure time of secondary ESD was significantly longer than primary ESD (78.2 min vs 55.1 min, P = 0.004), and the adverse events rate was not significantly different but trended slightly higher in the secondary ESD group compared to the primary ESD group (10.7% vs 3.8%, P = 0.095). Patients who received secondary ESD had favorable outcomes without severe adverse events. During a mean follow-up period, no local recurrence occurred in patients who received secondary ESD.

CONCLUSION:

Secondary ESD of residual or locally recurrent gastric tumors appears to be a feasible and curative treatment though it requires greater technical efficiency and longer procedure time.

KEYWORDS:

Endoscopic submucosal dissection; Gastric neoplasms; Recurrent tumors; Residual tumors; Secondary endoscopic submucosal dissection

PMID:
30197483
PMCID:
PMC6127657
DOI:
10.3748/wjg.v24.i33.3776
[Indexed for MEDLINE]
Free PMC Article

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