The potential risk of peritoneal seeding following perforation caused by endoscopic mucosal resection or endoscopic submucosal dissection is unknown.
Between 1991 and 2003, 90 patients suffered gastric perforation during endoscopic mucosal resection or endoscopic submucosal dissection at the National Cancer Centre Hospital, Tokyo.
Dr Ikehara and colleagues from Japan retrospectively assessed the clinical and pathological evidence for peritoneal dissemination in these patients.
The team followed 84 patients for a median of 54 months.
The team followed up the remaining 6 patients at other institutions.
In 83 patients the perforation was repaired by endoscopic clip application and 7 patients underwent emergency surgery.
|Peritoneal fluid was cytologically negative for malignancy in 9 patients|
|British Journal of Surgery|
The research team reported that gastrectomy was carried out in 33 patients who had non-curative endoscopic surgery.
Among these, peritoneal fluid was sampled during operation in 9 patients, and was cytologically negative for malignancy.
The researchers found that the other 24 patients who had a gastrectomy did not have ascites, so cytology was not performed.
Dr Ikehara's team concluded, "No peritoneal dissemination was noted during follow-up."
"This study suggests that perforation associated with endoscopic mucosal resection and endoscopic submucosal dissection does not lead to peritoneal dissemination even in the long term."