Clinical outcomes of double endoscopic intralumenal surgery for early gastric cancer

Abstract

Endoscopic submucosal dissection (ESD) is a safe, efficacious, and minimally invasive technique for superficial gastrointestinal neoplasms. However, the procedure is long, complex, and associated with higher complication rates. To overcome such limitations, the authors devised a double endoscopic intralumenal operation (DEILO) and assessed its efficacy and safety for superficial gastric neoplasms. The DEILO procedure was performed for 31 gastric cancers. This novel technique is characterized by the use of two endoscopes, one for lifting lesions and the other for cutting them, inserted into the stomach simultaneously. The DEILO technique was performed successfully, and en bloc resection was achieved for 29 (93.5%) of 31 patients. Histologically, curative resection was achieved for 26 lesions (83.8%). The mean operating time for DEILO was 34 min (range, 20-107 min). Two patients experienced postoperative hemorrhage, which was controlled endoscopically. Perforation occurred in two cases (6.4%), both of which were successfully treated nonsurgically. The DEILO procedure appears to shorten the operating time for ESD, with comparable efficacy and complication rates.