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- Title
Endoscopic resection and laparoscopic lymph node dissection for early gastric cancer beyond conventional endoscopic treatment indications: a 10-year outcome study.
- Authors
Lee, Ah Young; Kim, Yong Jin; Cho, Sungwoo; Lee, Tae Hee; Seo, Jun-Young; Kim, Seong Hwan; Cho, Joo Young
- Abstract
Background: Endoscopic full-thickness gastric resection (EFTGR) with laparoscopic regional lymph node dissection (LLND) and endoscopic submucosal dissection (ESD) with LLND have been investigated as treatment options for early gastric cancer beyond the absolute indications for ESD. However, comparative studies on the long-term outcomes of these procedures are lacking. This study aimed to analyze and compare the 10-year outcomes of both procedures in a real clinical setting. Methods: Between January 2009 and December 2013, 28 and 37 patients diagnosed with EGC beyond the absolute indications for ESD were treated with EFTGR with LLND and ESD with LLND, respectively. In both procedures, the dye was injected into the tumor. However, after injection and LLND, EFTGR was performed immediately in the EFTGR with LLND group, whereas LLND was followed by ESD in the ESD with LLND group. The primary endpoint was the 10-year survival rate. Results: The EFTGR with LLND group had one case of local recurrence (3.6%) and mortality (3.6%) each, while the ESD with LLND group had none (0.0% for both); however, the differences were not statistically significant (P = 0.247 for each). Furthermore, there was no significant difference in complications such as ischemia and anastomosis leakage between the groups (P = 0.247). Conclusions: When the procedures were properly applied, EFTGR with LLND and ESD with LLND did not increase the 10-year mortality in patients with EGC beyond the absolute ESD indications compared with conventional radical gastrectomy.
- Subjects
STOMACH tumors; LYMPHADENECTOMY; CANCER relapse; ISCHEMIA; LAPAROSCOPIC surgery; SURGICAL anastomosis; SCIENTIFIC observation; FISHER exact test; TREATMENT effectiveness; DESCRIPTIVE statistics; RETROSPECTIVE studies; MANN Whitney U Test; SURGICAL complications; LONGITUDINAL method; ENDOSCOPIC gastrointestinal surgery; MEDICAL records; ACQUISITION of data; SURVIVAL analysis (Biometry); DATA analysis software; PROGRESSION-free survival
- Publication
Surgical Endoscopy & Other Interventional Techniques, 2024, Vol 38, Issue 5, p2533
- ISSN
1866-6817
- Publication type
Article
- DOI
10.1007/s00464-024-10761-7