The international emergence of endoscopic submucosal dissection for early gastric cancer

Wang, Andrew Y.

doi:10.1016/j.gie.2011.01.016

Cited by 7 publications

(3 citation statements)

References 24 publications

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“…When multifocal, extensive, or incomplete gastric IM are found, we believe that surveillance endoscopy is reasonable, which we and others[ 20 ] conduct at 3-year intervals in the absence of any dysplasia. If focal areas of dysplasia or early gastric cancers are found, then we offer endoscopic mucosal resection or endoscopic submucosal dissection[ 44 , 45 ], when appropriate[ 46 ], in addition to more frequent endoscopic surveillance. Again, in this context, our data demonstrated that the presence of gastric IM is clinically significant, as this condition was associated with the pathologic findings of gastric dysplasia and cancer.…”

Section: Discussionmentioning

confidence: 99%

Gastric intestinal metaplasia is associated with gastric dysplasia but is inversely correlated with esophageal dysplasia

Gomez

Patrie

Bleibel

et al. 2017

WJGE

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AIMTo determine which clinical factors might be associated with gastric intestinal metaplasia (IM) in a North American population.METHODSPathology and endoscopy databases at an academic medical center were reviewed to identify patients with and without gastric IM on biopsies for a retrospective cohort study. Patient demographics, insurance status, and other clinical factors were reviewed.RESULTSFour hundred and sixty-eight patients with gastric IM (mean age: 61.0 years ± 14.4 years, 55.5% female) and 171 without gastric IM (mean age: 48.8 years ± 20.8 years, 55.0% female) were compared. The endoscopic appearance of atrophic gastritis correlated with finding gastric IM on histopathology (OR = 2.05, P = 0.051). Gastric IM was associated with histologic findings of chronic gastritis (OR = 2.56, P < 0.001), gastric ulcer (OR = 6.97, P = 0.015), gastric dysplasia (OR = 6.11, P = 0.038), and gastric cancer (OR = 6.53, P = 0.027). Histologic findings of Barrett’s esophagus (OR = 0.28, P = 0.003) and esophageal dysplasia (OR = 0.11, P = 0.014) were inversely associated with gastric IM. Tobacco use (OR = 1.73, P = 0.005) was associated with gastric IM.CONCLUSIONPatients who smoke or have the endoscopic finding of atrophic gastritis are more likely to have gastric IM and should have screening gastric biopsies during esophagogastroduodenoscopy (EGD). Patients with gastric IM are at increased risk for having gastric dysplasia and cancer, and surveillance EGD with gastric biopsies in these patients might be reasonable.

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Section: Discussionmentioning

confidence: 99%

Gastric intestinal metaplasia is associated with gastric dysplasia but is inversely correlated with esophageal dysplasia

Gomez

Patrie

Bleibel

et al. 2017

WJGE

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“…ESD, however, is technically challenging and is rarely practiced outside of Japan or Korea [1]. A steep learning curve to master ESD, prolonged procedure duration, increased procedure risks, lack of commensurate reimbursement, and need for specialized tools have become challenges in mastering ESD [2]. Endoscopic mucosal resection (EMR) is technically less demanding and seen by many as an alternate method of endoscopic resection for early GI neoplasia.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Submucosal Dissection Outcomes for Gastroesophageal Tumors in Low Volume Units: A Multicenter Survey

Azmi

Khor

et al. 2016

Diagnostic and Therapeutic Endoscopy

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Background and Aims. Endoscopic submucosal dissection (ESD) outcomes have traditionally been reported from high volume centers in East Asia. Data from low volume centers in other parts of Asia remain sparse. Methods. A retrospective survey with a structured questionnaire of 5 tertiary centers in 3 countries in South East Asia was conducted. Details of training and clinical outcomes of ESD cases, with follow-up data from these centers, were analyzed. Results. Seven endoscopists from the 5 centers performed a total of 35 cases of ESD in the upper gastrointestinal tract (UGIT) over a 6-year duration. Details of the lesions excised were as follows: median size was 20 mm, morphologically 20 (68.6%) were flat/depressed and 6 (17.1%) were submucosal, and histologically 27 (77.1%) were neoplastic. The median duration of ESD procedures was 105 minutes, with an en-bloc resection rate of 91.4%. There was 1 (2.9%) case of delayed bleeding, but no perforation nor mortality in any of the cases. The recurrence rate after ESD was 5.7%. A prolonged ESD duration was influenced by a larger size of lesion (25 mm, p = 0.02) but not by factors related to the training experience of endoscopists. Conclusions. ESD in the UGIT is feasible and safe in low volume centers in Asia.

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“…La DSE es un procedimiento difícil que requiere el aprendizaje de maniobras que no se realizan en la endoscopia terapéutica más común como el corte circunferencial o el corte lateral, caracterizándose su entrenamiento por una curva de aprendizaje prolongada que precisa un entrenamiento inicial en modelo animal. Si bien todas las técnicas endoscópicas tienen 2 componentes, técnico y cognitivo, la DSE añade la dificultad de requerir una capacidad constante de toma de decisiones que abarca la detección de la displasia en la evaluación inicial de la lesión, la definición de los bordes adecuados de resección, la selección de los accesorios endoscópicos más apropiados, la identificación de los vasos submucosos que se exponen durante la disección para su coagulación y la exposición del plano más adecuado para la disección de la capa submucosa 6 . La DSE es una técnica endoscópica consolidada en Oriente y progresivamente se asiste a una diseminación lenta en Occidente 7 .…”

Section: Introductionunclassified

Disección submucosa endoscópica, ¿solo para endoscopistas expertos?

Nicolás–Pérez

2012

Gastroenterología y Hepatología

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The international emergence of endoscopic submucosal dissection for early gastric cancer

Cited by 7 publications

References 24 publications

Gastric intestinal metaplasia is associated with gastric dysplasia but is inversely correlated with esophageal dysplasia

Gastric intestinal metaplasia is associated with gastric dysplasia but is inversely correlated with esophageal dysplasia

Endoscopic Submucosal Dissection Outcomes for Gastroesophageal Tumors in Low Volume Units: A Multicenter Survey

Disección submucosa endoscópica, ¿solo para endoscopistas expertos?

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