Applying Endoscopic Submucosal Dissection for Treating Early Gastric Cancer

Abstract

Introduction: Endoscopic submucosal dissection (ESD) is a standard method for the treatment of early gastric cancer and low risk of lymph node metastasis. Its advantage is to obtain a higher negative edge rate than mucosal resection and less trauma than surgery. Objectives: The short-term prognosis, pathological anatomy and long-term survival of ESD patients in our center were analyzed. Methods: Descriptive research. The clinical records of patients with early gastric injury treated with ESD from January 2008 to June 2012 were reviewed. Results: There were 15 patients included, 8 males and 7 females. The median age was 70 years (45–88). Tumor location: 2 cases in the upper third, 5 cases in the middle third and 8 cases in the lower third. The median tumor size was 13.5 mm (6–21). Most injuries are IIc. Among the postoperative complications, 1 case of gastrointestinal bleeding was treated by endoscopy and 3 cases of gastric perforation (gastric anastomosis) were treated by surgery. The average hospitalization was 3 days (1–23). There was no death record after operation. 86.7% of the cases had a negative edge. One case was positive at the deep edge after subtotal gastrectomy, and the other case was positive at the lateral edge. A new ESD treatment was used. The median follow-up was 16 months (7–61), and there was no pathological death of tumor. One case of tumor recurrence (51 months) was treated surgically. Conclusion: ESD is an alternative to the treatment of early gastric injury, allowing a high proportion of negative edges.