Simultaneous endoscopic submucosal dissection for multiple early gastric cancers in a low volume center

Abstract

The aim of the study is to evaluate the safety and efficacy of simultaneous endoscopic submucosal dissection (ESD) for multiple early gastric cancers.A total of 70 solitary early gastric cancers from 70 patients and 20 multiple early gastric cancers from 10 patients were included in this retrospective study. The curative resection rate, en bloc resection rate, procedure-related complications, and local recurrence were compared between the 2 groups.There was no statistical difference in the rate of complete resection, en bloc resection, and curative resection between the 2 groups (P > .05). No significant difference was found with respect to the occurrence of postoperative bleeding (P > .05). Procedure time was significantly longer in the simultaneous group than that in the single group (87.6 ± 25.1 min vs 54.6 ± 22.0 min, P = .004). The overall incidence of synchronous early gastric cancer was 7.5%.Simultaneous ESD for multiple early gastric cancers is a safe and feasible choice in low-volume hospital. The entire stomach should be examined meticulously during and after ESD. Larger randomized studies are needed to validate our results.

Synchronous double superficial mixed gastrointestinal mucus phenotype gastric cancer with gastritis cystica profunda and submucosal lipoma

“…Based on previous reports, the synchronous multifocal gastric cancer accounts for 4.8% to 20.9% of surgically resected stomachs, is more commonly associated with early gastric cancer (EGC), and multiple EGCs account for 6% to 14% of all EGCs. [4,5] EGC frequently develops in the lower third of the stomach. However, multiple EGCs are frequently located in different parts of the stomach (upper, middle, or lower thirds), which are important blind spots in endoscopic examination.…”

“…However, multiple EGCs are frequently located in different parts of the stomach (upper, middle, or lower thirds), which are important blind spots in endoscopic examination. [5] In addition, male sex and submucosal invasion were predictive risk factors of synchronous multiple EGC. [1] Therefore, patients with risk factors should undergo more meticulous endoscopic examination during endoscopic screening and endoscopic tumor resection, in order to avoid being overlooked.…”