Endoscopic mucosal resection is currently a standard treatment for mucosal gastric tumors.
Endoscopic submucosal dissection has been developed for en bloc resection.
Dr Kenichiro Watanabe and research team evaluated the clinical outcomes of endoscopic submucosal dissection vs conventional resection.
The team performed a historical control study between the 2 techniques.
Endoscopic mucosal resection of 245 gastric tumors was performed in 229 patients.
The investigative team divided the lesions into 2 groups.
Conventional resection was performed in Group 1 from 1999 to 2001.
Endoscopic submucosal dissection was performed in Group 2 from 2001 to 2004.
|Perforation rates were not different between groups|
Group 2 was further divided into subgroups.
The first subgroup underwent endoscopic submucosal dissection from 2001 to 2003, and the second from 2003 to 2004.
The investigators resected all lesions with either conventional resection or with endoscopic submucosal dissection.
En bloc resection rate, rate in completeness of resection, required time, remnant ratio, and complications were evaluated.
The investigators identified the en bloc resection rate of lesions more than 10 mm in size.
The team found that the rate in completeness of resection of Group 2 was significantly higher than that of Group 1.
Although the required time was longer in Group 2 than Group 1, it was shorter in the second subgroup compared with the first in smaller lesions.
The team observed that the remnant ratios and perforation rates were not different between groups.
Dr Watanabe's team concluded, “The en bloc resection rate was better with endoscopic submucosal dissection than with conventional resection.”
“The required time was longer in endoscopic submucosal dissection, but this disadvantage might be improved with experience.”