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- Title
Endoscopic submucosal dissection for early gastric cancer using a cross-counter technique.
- Authors
Okamoto, Koichi; Okamura, Seisuke; Muguruma, Naoki; Kitamura, Shinji; Kimura, Tetsuo; Imoto, Yoshitaka; Miyamoto, Hiroshi; Okahisa, Toshiya; Takayama, Tetsuji
- Abstract
Background and study aims: Endoscopic submucosal dissection (ESD) in early gastric cancer has rapidly come into widespread use. However, since complications such as bleeding and perforation often occur, and the procedure time is longer for ESD than endoscopic mucosal resection (EMR), development of safer and more reliable technique is required. Patients and methods: The subjects comprised 45 patients with lesions diagnosed histologically as early gastric cancer. They were divided into three groups: cross-counter technique group (CC, n = 15), peroral traction-assisted ESD with suture material group (PT, n = 15), and no-traction group (NT, n = 15). ESD was carried out by two endoscopists who had experienced fewer than 30 cases of ESD. To compare safety and efficacy of a new traction method (CC group) for ESD in early gastric cancer with other methods (PT group and NT group), procedure time, dissected area per unit time, complete resection rate, perforation rate, and bleeding rate were evaluated. Results: There was no significant difference among these three groups in terms of complications, complete resection rate or procedure time. The dissection area per unit time was 22.4, 15.7, and 13.5 mm/min in the CC, PT, and NT groups, respectively, and there was a significant difference between the CC and NT groups ( p = 0.007). Conclusions: The cross-counter technique shortened the treatment time for endoscopists without abundant experience in gastric ESD, and it is considered a useful method to institute in order to introduce ESD.
- Subjects
STOMACH cancer treatment; ENDOSCOPIC surgery complications; STOMACH surgery complications; CANCER treatment complications; SURGICAL excision
- Publication
Surgical Endoscopy & Other Interventional Techniques, 2012, Vol 26, Issue 12, p3676
- ISSN
1866-6817
- Publication type
Article
- DOI
10.1007/s00464-012-2364-7