Shin Na1, Gin Hyug Lee, Ju Hyung Song, Ji Yong Ahn, Seon-Ok Kim, Se Jeong Park, So-Eun Park, Mi-Young Kim, Jeonghoon Lee, Kwi-Sook Choi, Do Hoon Kim, Ho June Song, Kee Don Choi, Hwoon-Yong Jung, Jin-Ho Kim. 1. 1 Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Asan Digestive Disease Research Institute, Seoul, Korea. 2 Department of Clinical Epidemiology and Biostatistics, University of Ulsan College of Medicine, Asan Medical Center, Korea. 3 Address correspondence to: Gin Hyug Lee, M.D., Ph.D., Department of Gastroenterology, University of Ulsan College of Medicine Asan Medical Center, Asan Digestive Disease Research Institute, 388-1 Pungnap-2 dong, Songpa-gu, Seoul, 138-736, Korea.
Abstract
BACKGROUND: The aim of this study was to investigate the feasibility and safety of endoscopic resection of gastric neoplasm in solid-organ transplant (SOT) recipients. METHODS: Between January 1994 and December 2011, the results of endoscopic resection of 17 lesions in 15 consecutive patients who had previously undergone SOT at Asan Medical Center were retrospectively evaluated. We compared clinical outcomes of this group with 1:5 matched non-SOT patients treated by endoscopic resection. RESULTS: Of the 6,491 patients who underwent SOT during the study periods, 30 patients (0.46%) with 31 lesions were diagnosed with gastric cancer, and eight patients (0.12%) with nine lesions were diagnosed with gastric adenoma. Among them, 15 patients with 17 lesions were treated by endoscopic resection, and 19 patients with 20 lesions have undergone gastrectomy. In endoscopically resected SOT group, the median duration between transplantation and endoscopic treatment was 41 months (range, 5-196 months). En bloc and complete resection were achieved in 13 (76.5%) and 15 (88.2%) lesions. Four lesions (23.5%) experienced bleeding, which was successfully managed endoscopically. When compared with post-endoscopic resection bleeding rate of non-SOT group (5.9%, [5/85]), there was no significant difference in multivariable analysis (P=0.083). CONCLUSIONS: In endoscopic resection for gastric neoplasm of SOT recipients, only manageable complications were noted in some patients, and graft dysfunctions or perforations did not occur. To avoid surgical resection with its associated perioperative mortality and morbidity, endoscopic resection for gastric neoplasm in SOT recipients is recommended as a feasible treatment with high efficacy and safety.
BACKGROUND: The aim of this study was to investigate the feasibility and safety of endoscopic resection of gastric neoplasm in solid-organ transplant (SOT) recipients. METHODS: Between January 1994 and December 2011, the results of endoscopic resection of 17 lesions in 15 consecutive patients who had previously undergone SOT at Asan Medical Center were retrospectively evaluated. We compared clinical outcomes of this group with 1:5 matched non-SOTpatients treated by endoscopic resection. RESULTS: Of the 6,491 patients who underwent SOT during the study periods, 30 patients (0.46%) with 31 lesions were diagnosed with gastric cancer, and eight patients (0.12%) with nine lesions were diagnosed with gastric adenoma. Among them, 15 patients with 17 lesions were treated by endoscopic resection, and 19 patients with 20 lesions have undergone gastrectomy. In endoscopically resected SOT group, the median duration between transplantation and endoscopic treatment was 41 months (range, 5-196 months). En bloc and complete resection were achieved in 13 (76.5%) and 15 (88.2%) lesions. Four lesions (23.5%) experienced bleeding, which was successfully managed endoscopically. When compared with post-endoscopic resection bleeding rate of non-SOT group (5.9%, [5/85]), there was no significant difference in multivariable analysis (P=0.083). CONCLUSIONS: In endoscopic resection for gastric neoplasm of SOT recipients, only manageable complications were noted in some patients, and graft dysfunctions or perforations did not occur. To avoid surgical resection with its associated perioperative mortality and morbidity, endoscopic resection for gastric neoplasm in SOT recipients is recommended as a feasible treatment with high efficacy and safety.