BACKGROUND: Endoscopic submucosal dissection (ESD) is curative treatment for patients with early gastric cancer (EGC). Because of the technical difficulties, however, these procedures may take a long time, which can increase the rate of procedure-related complications. OBJECTIVE: To investigate the procedure time of ESD performed by 4 experts according to the location and size of the EGC. DESIGN: Retrospectively analyzed study of prospectively collected data. SETTING: Tertiary care, academic medical center. PATIENTS: Complete ESDs were performed by 4 experts, primarily using an insulated-tip knife, for 916 EGCs. INTERVENTION: ESD. MAIN OUTCOME MEASUREMENT: Procedure time relative to the location and size of tumors was analyzed along with other predictive factors. RESULTS: ESD procedure time was increased as tumor size increased and for tumors in the middle and lower thirds of the stomach. Univariate analysis showed that tumor size, location, depth, submucosal fibrosis, and perforation during the procedure were significant predictors of procedure time. Multivariate analysis showed that proximal location, tumor size greater than 20 mm, submucosal fibrosis, and perforation during the procedure were independent predictors of a longer procedure time. LIMITATION: Single-center, retrospective study design. CONCLUSIONS: Procedure time became longer as tumor location became higher and as tumor size increased, except for tumors in the upper third of the stomach. These findings suggest that tumor size and location may be useful in predicting the time required to perform ESD.
BACKGROUND: Endoscopic submucosal dissection (ESD) is curative treatment for patients with early gastric cancer (EGC). Because of the technical difficulties, however, these procedures may take a long time, which can increase the rate of procedure-related complications. OBJECTIVE: To investigate the procedure time of ESD performed by 4 experts according to the location and size of the EGC. DESIGN: Retrospectively analyzed study of prospectively collected data. SETTING: Tertiary care, academic medical center. PATIENTS: Complete ESDs were performed by 4 experts, primarily using an insulated-tip knife, for 916 EGCs. INTERVENTION: ESD. MAIN OUTCOME MEASUREMENT: Procedure time relative to the location and size of tumors was analyzed along with other predictive factors. RESULTS: ESD procedure time was increased as tumor size increased and for tumors in the middle and lower thirds of the stomach. Univariate analysis showed that tumor size, location, depth, submucosal fibrosis, and perforation during the procedure were significant predictors of procedure time. Multivariate analysis showed that proximal location, tumor size greater than 20 mm, submucosal fibrosis, and perforation during the procedure were independent predictors of a longer procedure time. LIMITATION: Single-center, retrospective study design. CONCLUSIONS: Procedure time became longer as tumor location became higher and as tumor size increased, except for tumors in the upper third of the stomach. These findings suggest that tumor size and location may be useful in predicting the time required to perform ESD.
Authors: Ji Young Yoon; Choong Nam Shim; Sook Hee Chung; Wan Park; Hyunsoo Chung; Hyuk Lee; Sung Kwan Shin; Sang Kil Lee; Yong Chan Lee; Jun Chul Park Journal: World J Gastroenterol Date: 2014-07-14 Impact factor: 5.742
Authors: Ji Ha Kim; Hyeong Seok Nam; Cheol Woong Choi; Dae Hwan Kang; Hyung Wook Kim; Su Bum Park; Su Jin Kim; Sun Hwi Hwang; Si Hak Lee Journal: Surg Endosc Date: 2016-08-05 Impact factor: 4.584
Authors: Zhong-Sheng Lu; Yun-Sheng Yang; Dan Feng; Shu-Fang Wang; Jing Yuan; Jin Huang; Xiang-Dong Wang; Jiang-Yun Meng; Hong Du; Hong-Bin Wang Journal: World J Gastroenterol Date: 2012-12-21 Impact factor: 5.742