A new disk method for the endoscopic determination of gastric ulcer area

Fujishiro

et al. 2015

535

500

In response to the rapid and wide acceptance and use of endoscopic treatments for early gastric cancer, the Japan Gastroenterological Endoscopy Society (JGES), in collaboration with the Japanese Gastric Cancer Association (JGCA), has produced ‘Guidelines for ESD and EMR for Early Gastric Cancer’, as a set of basic guidelines in accordance with the principles of evidence‐based medicine. These Guidelines cover the present state of knowledge and are divided into the following seven categories: Indications, Preoperative diagnosis, Techniques, Evaluation of curability, Complications, Long‐term postoperative surveillance, and Histology. Twenty‐three statements were finally accepted as guidelines, and the majority of these were obtained from descriptive studies with lower evidence levels. A number of statements had to be created by consensus (the lowest evidence level), as evidence levels remain low for many specific areas in this field.

Section: Procedures For the Production Of Guidelines For Esd And Emr Fmentioning

confidence: 99%

Guidelines for endoscopic submucosal dissection and endoscopic mucosal resection for early gastric cancer

Ono

Fujishiro

et al. 2015

535

500

“…No report has systemically examined the diagnostic accuracy concerning the lesion size of early gastric cancer. In actual clinical practice, lesion size is estimated by comparison of the lesion and the diameter of the endoscope or biopsy forceps or by measurement using a measuring disc or measuring forceps 1–5 . However, the measurement of ulcers using biopsy forceps results in underestimation of lesion size by 26.5 ± 5.7% to 41.8 ± 3.3% 2 .…”

Section: Statement 4‐3mentioning

confidence: 99%

“…Endoscopic measurement of the lesion vary among and within endoscopists 5 . Thus, there are errors among size measurements obtained by endoscopic visual evaluation in relation to the observation distance and angle 1–5 . The tumor diameter indicated for endoscopic treatment was prescribed based on the histopathological findings.…”

Section: Statement 4‐3mentioning

confidence: 99%

Guidelines for endoscopic diagnosis of early gastric cancer

Uedo

Kamada

et al. 2020

153

144

The Japan Gastroenterological Endoscopy Society developed the Guideline for Endoscopic Diagnosis of Early Gastric Cancer based on scientific methods. Endoscopy for the diagnosis of early gastric cancer has been acknowledged as a useful and highly precise examination, and its use has become increasingly more common in recent years. However, the level of evidence in this field is low, and it is often necessary to determine recommendations based on expert consensus only. This clinical practice guideline consists of the following sections to provide the current guideline: [I] Risk stratification of gastric cancer before endoscopic examination, [II] Detection of early gastric cancer, [III] Qualitative diagnosis of early gastric cancer, [IV] Diagnosis to choose the therapeutic strategy for gastric cancer, [V] Risk stratification after endoscopic examination, and [VI] Surveillance of early gastric cancer.

“…A major disadvantage of endoscopy is that the lesion cannot be accurately measured visually because of the barrel distortion caused by the wide‐angle lens . In clinical practice, it is impossible to use a specialized technique such as a computerized image‐processing technique to correct barrel distortion, so comparative measurement with a rubber disk or open biopsy forceps as the reference device is the only applicable method. However, because this is still not very accurate, on principle, the size of the neoplasia should be measured in the resected specimen during histopathological investigation.…”

Section: Why and How Should Egc Be Characterized For Curative Esd?mentioning

confidence: 99%

Detection and characterization of early gastric cancer for curative endoscopic submucosal dissection

Nishizaki

Matsui

et al. 2013

Because endoscopic submucosal dissection (ESD) of gastric cancer can only be curative if the cancer is detected at an early stage and a precise preoperative diagnosis is made, we reviewed the detection and characterization of early gastric cancer (EGC) using both conventional endoscopy with white-light imaging (C-WLI) and image-enhanced endoscopy (chromoendoscopy [CE] and magnifying narrow-band imaging [M-NBI]). Systematic screening of the stomach by C-WLI after ideal preparation of the patient is important for detecting a mucosal lesion, which can then be characterized using CE. However, a limitation of C-WLI with CE is the diagnosis of flat or small gastric cancers. To overcome this, M-NBI together with a comprehensive diagnostic system, termed the 'vessel plus surface classification' system, was developed and has proven very useful. Preoperative assessment for ESD involves determining: (i) histological type; (ii) size; (iii) depth of invasion; (iv) presence or absence of associated ulceration; and (v) horizontal extent of the cancer. A limitation of endoscopic diagnosis using M-NBI is the histologically undifferentiated type of carcinoma, in which case the biopsy specimen is used to make a histopathological diagnosis.