Endoscopic submucosal dissection for early gastric cancers

Objective Endoscopic submucosal dissection （ESD） is a new diagnostic and therapeutical technique for early gastric cancer （EGC）. The aim of this study was to evaluate the efficacy and safety of ESD for EGC. Methods The data of patients who underwent ESD for EGCs from July 2007 to December 2007 were analyzed retrospectively. One-piece resection rate, histologically complete resection rate （the lateral and vertical margins were free of cancer） , operation time, complications, post-ESD ulcer-healing rates and local recurrence were assessed. Results A total of 21 EGCs in 20 consecutive patients were treated with ESD. The median age was 56.4 years （ range 37 - 75 years） and the male/female ratio was 1.9 （ 13/7 ）. Out of 21 lesions, 20 （95.2%） were resected in one piece. The rate for one-piece resection with tumor-free margins was 90. 5% （ 19/21 ）. Acute minor bleeding during the ESD procedure occurred in 4. 8% （ 1/21 ）. Post-ESD epigastfie pain rate was 76. 2% （ 16/21 ）. No acute major bleeding, delayed bleeding and perforation occurred. The median operation time was 50.4 min （ range 45 - 200 min）. The post-ESD ulcer-healing rates was 100% after 8 weeks of oral esomeprazole. After a follow-up with median time of 9.2 months （ range 8 - 12 months）, none of the patients experienced residual/local recurrence of early gastric cancer. Conclusion ESD has the advantage of increasing one-piece resection rate and histologically curative resection rates. ESD is a safe and effective treatment for EGC. Key words: Stomach neoplasms ;  Enoscopy,gastrointestinal;  Endoscopic submucosal dissection