Comparison of Endoscopic Submucosal Dissection With Endoscopic Mucosal Resection After Circumferential Precutting to Treat Gastric Adenomas ≤15 mm
Objectives Endoscopic submucosal dissection (ESD) is a widely used approach for the resection of superficial gastric neoplastic lesions. Endoscopic mucosal resection (EMR) is acceptable for lesions <10–15 mm in size. Herein, we compared the clinical outcomes of ESD with those of EMR after circumf...
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Korean College of Helicobacter and Upper Gastrointestinal Research
2024-03-01
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| Series: | The Korean Journal of Helicobacter and Upper Gastrointestinal Research |
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| Online Access: | http://helicojournal.org/upload/pdf/kjhugr-2023-0046.pdf |
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| author | Jin Lee Junghwan Lee Ji Eun Na Yong Eun Park Joon Hyuk Choi Nae-Yun Heo Seung Ha Park Tae Oh Kim Jongha Park |
| author_facet | Jin Lee Junghwan Lee Ji Eun Na Yong Eun Park Joon Hyuk Choi Nae-Yun Heo Seung Ha Park Tae Oh Kim Jongha Park |
| author_sort | Jin Lee |
| collection | DOAJ |
| description | Objectives Endoscopic submucosal dissection (ESD) is a widely used approach for the resection of superficial gastric neoplastic lesions. Endoscopic mucosal resection (EMR) is acceptable for lesions <10–15 mm in size. Herein, we compared the clinical outcomes of ESD with those of EMR after circumferential precutting (EMR-P) for gastric adenomas ≤15 mm. Methods We retrospectively analyzed the data of 213 patients with 228 gastric adenomas ≤15 mm in size who were treated endoscopically at a single tertiary hospital in Korea between November 2018 and October 2022. We evaluated the complete endoscopic resection rate, recurrence rate, procedurer-elated complications, and procedure time according to the procedure used. Results Among the 228 gastric adenomas, 49 were treated with EMR-P and 179 with ESD. The histological complete resection rate was higher in the ESD group than in the EMR-P group (87% vs. 57%, p<0.001). No significant between-group differences were observed in endoscopic en bloc resection rates (ESD vs. EMR-P, 96% vs. 90%; p=0.081). The procedure time was significantly shorter in the EMR-P group than in the ESD group (28.9±19.7 min vs. 8.8±5.9 min, p<0.001). The local recurrence rate in patients with histologically incomplete resection did not differ between the two groups (ESD vs. EMR-P, 8.7% vs. 9.5%; p=0.924). Conclusions For gastric adenomas ≤15 mm, EMR-P may be the preferable treatment method considering the en bloc resection rate, procedure time, and local recurrence rate. However, considering the complete resection rate, ESD is recommended as the treatment of choice for high-grade adenomas and early gastric cancer lesions. |
| format | Article |
| id | doaj-art-e8dc8e0c4e3d4ec8acb5529fe00c8d27 |
| institution | DOAJ |
| issn | 1738-3331 |
| language | English |
| publishDate | 2024-03-01 |
| publisher | Korean College of Helicobacter and Upper Gastrointestinal Research |
| record_format | Article |
| series | The Korean Journal of Helicobacter and Upper Gastrointestinal Research |
| spelling | doaj-art-e8dc8e0c4e3d4ec8acb5529fe00c8d272025-08-20T03:19:08ZengKorean College of Helicobacter and Upper Gastrointestinal ResearchThe Korean Journal of Helicobacter and Upper Gastrointestinal Research1738-33312024-03-01241586310.7704/kjhugr.2023.0046823Comparison of Endoscopic Submucosal Dissection With Endoscopic Mucosal Resection After Circumferential Precutting to Treat Gastric Adenomas ≤15 mmJin Lee0Junghwan Lee1Ji Eun Na2Yong Eun Park3Joon Hyuk Choi4Nae-Yun Heo5Seung Ha Park6Tae Oh Kim7Jongha Park Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, KoreaObjectives Endoscopic submucosal dissection (ESD) is a widely used approach for the resection of superficial gastric neoplastic lesions. Endoscopic mucosal resection (EMR) is acceptable for lesions <10–15 mm in size. Herein, we compared the clinical outcomes of ESD with those of EMR after circumferential precutting (EMR-P) for gastric adenomas ≤15 mm. Methods We retrospectively analyzed the data of 213 patients with 228 gastric adenomas ≤15 mm in size who were treated endoscopically at a single tertiary hospital in Korea between November 2018 and October 2022. We evaluated the complete endoscopic resection rate, recurrence rate, procedurer-elated complications, and procedure time according to the procedure used. Results Among the 228 gastric adenomas, 49 were treated with EMR-P and 179 with ESD. The histological complete resection rate was higher in the ESD group than in the EMR-P group (87% vs. 57%, p<0.001). No significant between-group differences were observed in endoscopic en bloc resection rates (ESD vs. EMR-P, 96% vs. 90%; p=0.081). The procedure time was significantly shorter in the EMR-P group than in the ESD group (28.9±19.7 min vs. 8.8±5.9 min, p<0.001). The local recurrence rate in patients with histologically incomplete resection did not differ between the two groups (ESD vs. EMR-P, 8.7% vs. 9.5%; p=0.924). Conclusions For gastric adenomas ≤15 mm, EMR-P may be the preferable treatment method considering the en bloc resection rate, procedure time, and local recurrence rate. However, considering the complete resection rate, ESD is recommended as the treatment of choice for high-grade adenomas and early gastric cancer lesions.http://helicojournal.org/upload/pdf/kjhugr-2023-0046.pdfadenomastomach neoplasmsendoscopic mucosal resection |
| spellingShingle | Jin Lee Junghwan Lee Ji Eun Na Yong Eun Park Joon Hyuk Choi Nae-Yun Heo Seung Ha Park Tae Oh Kim Jongha Park Comparison of Endoscopic Submucosal Dissection With Endoscopic Mucosal Resection After Circumferential Precutting to Treat Gastric Adenomas ≤15 mm The Korean Journal of Helicobacter and Upper Gastrointestinal Research adenoma stomach neoplasms endoscopic mucosal resection |
| title | Comparison of Endoscopic Submucosal Dissection With Endoscopic Mucosal Resection After Circumferential Precutting to Treat Gastric Adenomas ≤15 mm |
| title_full | Comparison of Endoscopic Submucosal Dissection With Endoscopic Mucosal Resection After Circumferential Precutting to Treat Gastric Adenomas ≤15 mm |
| title_fullStr | Comparison of Endoscopic Submucosal Dissection With Endoscopic Mucosal Resection After Circumferential Precutting to Treat Gastric Adenomas ≤15 mm |
| title_full_unstemmed | Comparison of Endoscopic Submucosal Dissection With Endoscopic Mucosal Resection After Circumferential Precutting to Treat Gastric Adenomas ≤15 mm |
| title_short | Comparison of Endoscopic Submucosal Dissection With Endoscopic Mucosal Resection After Circumferential Precutting to Treat Gastric Adenomas ≤15 mm |
| title_sort | comparison of endoscopic submucosal dissection with endoscopic mucosal resection after circumferential precutting to treat gastric adenomas ≤15 mm |
| topic | adenoma stomach neoplasms endoscopic mucosal resection |
| url | http://helicojournal.org/upload/pdf/kjhugr-2023-0046.pdf |
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