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Search Results: 1 - 10 of 2011 matches for " Endoscopic Submucosal Dissection "
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Endoscopic Submucosal Dissection for Early Gastric Cancer  [PDF]
Kouichi Nonaka, Hiroto Kita
Journal of Cancer Therapy (JCT) , 2013, DOI: 10.4236/jct.2013.41A004
Abstract: The field of endoscopy has progressed markedly and become widespread in recent years, and the role of minimally invasive endoscopic treatment has become increasingly more important with the increase in the number of patients in whom gastric cancer is detected at an early stage. In addition, the characteristics of early gastric cancer, which can be curably treated by mucosal resection alone just as by surgical cancer resection, were clarified, and endoscopic submucosal dissection (ESD) was developed as a highly curable, minimally invasive treatment, that is gaining popularity. In this paper, we describe the technical details and complications of ESD for early gastric cancer, including their management.
Clinical Impact of Endoscopic Submucosal Dissection for Early Gastric Cancer  [PDF]
Takashi Kosaka, Masaki Endo, Yousuke Toya, Tomomi Mizutani, Yukito Abiko, Norihiko Kudara, Masaaki Inomata, Toshimi Chiba, Yasuhiro Takikawa, Kazuyuki Suzuki, Tamotsu Sugai
Journal of Cancer Therapy (JCT) , 2013, DOI: 10.4236/jct.2013.41A009

Aim: The aim of this study was to examine the safety and efficacy of endoscopic submucosal dissection (ESD) for early gastric cancer based on approximately 10 years’ experience. Methods: Endoscopic submucosal dissection was performed in 1272 patients with early gastric cancer (1657 lesions). We examined en bloc resection rate, curative resection rate, local recurrence rate, procedure time, and complications. Results: The overall en bloc resection rate was 98.6% for all lesions treated by ESD. The median procedure time of the operation was 54.3 minutes (range 5 - 632 min). The incidence of positive horizontal and vertical margins was 3.8% and 4.0%, respectively. The incidence was 2.5% each for perforation and postoperative bleeding. There were no deaths related to ESD. Local recurrence was observed in 10 lesions (0.06%). Conclusion: Since the procedure time and incidence of complications have been reduced, endoscopic submucosal dissection has been considered a standard treatment for early gastric cancer.

Endoscopic Staging and Treatment of Early Gastric Cancer  [PDF]
Angel Ferrández, Sonia Mostacero, Angel Lanas
Journal of Cancer Therapy (JCT) , 2013, DOI: 10.4236/jct.2013.41A013

Gastric cancer is the most common cancer worldwide and it is often diagnosed in an advanced stage. In countries where screening endoscopy is performed widely, early detection is possible. In fact, early gastric cancer incidence is increasing during the last years worldwide and screening could be a major factor in such increase. In the past, the standard treatment of gastric cancer was surgical resection; however, the endoscopic treatment has increased due to advances in the instruments available and clinician experience. In fact, endoscopic resection has become one of the greatest advances in EGC treatment. It is the standard treatment in most of the cases because early gastric cancer is associated with a low rate of lymph node metastasis and a high survival rate. Endoscopic Mucosal Resection and more recently Endoscopic Submucosal Dissection are the two main developed procedures. Endoscopic Submucosal Dissection achieves a higher rate of en-bloc resection, complete resection, curative resection and lower local recurrence compared with Endoscopic Mucosal Resection group. The disadvantages associated with Endoscopic Submucosal Dissection, such as higher perforation rates and longer procedure time, will probably improve as the endoscopists experience increases and new endoscopic tools are developed. The aim of this paper is to review the management of EGC with a special focus on endoscopic detection, staging, therapy, surveillance, and prevention.

Worldwide experiences of endoscopic submucosal dissection: Not just Eastern acrobatics
Kwang Bum Cho,Won Joong Jeon,Jae J Kim
World Journal of Gastroenterology , 2011, DOI: 10.3748/wjg.v17.i21.2611
Abstract: The high incidence of gastric cancer has led to the initiation of cancer screening programs. As a result, the number of early gastric cancer cases has increased and consequentially, the cancer mortality rate has decreased. Moreover, the development of minimally invasive endoscopic treatment has been introduced for these early lesions. Endoscopic submucosal dissection (ESD) is now recognized as one of the preferred treatment modalities for premalignant gastrointestinal epithelial lesions and early gastric cancer without lymph node metastasis. We review the results of ESD including experiences in Japan and Korea, as well as western countries.
Laparoscopic Submucosal Dissection for Gastrointestinal Stromal Tumor of the Stomach: A Novel Technique for Local Excision with a Minimal Curative Margin  [PDF]
Norihito Wada, Yoshiro Saikawa, Hiroya Takeuchi, Tsunehiro Takahashi, Rieko Nakamura, Hirofumi Kawakubo, Kaori Kameyama, Makio Mukai, Yuko Kitagawa
Surgical Science (SS) , 2012, DOI: 10.4236/ss.2012.310098
Abstract: Background: Laparoscopic wedge resection is accepted as a curative treatment for small- and mediumsized gastroin-testinal stromal tumors (GISTs) of the stomach. Conventional methods involving surgical staplers require relatively large lateral margins, which may cause deformity and postoperative dysfunction of the gastric remnant. In this study, we introduce a novel technique called laparoscopic submucosal dissection (LSD) in which the defects of the stomach are minimized and a microscopic negative margin is secured. Methods: The normal seromuscular layer of the gastric wall was dissected with a 5 mm lateral margin. Then, the submucosal tissue was divided carefully using a monopolar electrosurgical device with a curved spatula tip. Results: The operation time was 170 min, and the amount of bleeding was very small. We confirmed an intact pseudo-capsule and marginal subserosal or submucosal tissue of the tumor by histological analysis. The postoperative course was uneventful with no complications. Endoscopy showed minimal deformity of the gastric remnant. Conclusions: We think that LSD is a curative and less invasive treatment for GIST of the stomach. Further investigations are necessary to evaluate the oncological and functional outcomes of this procedure.
- , 2018, DOI: 10.3969/j.issn.1007-1989.2018.04.022
Abstract: 摘要: 探讨结直肠黏膜下肿瘤的诊断及内镜黏膜下剥离术(ESD)治疗的疗效和安全性。方法?收集2011年1月-2017年1月在该院消化内镜中心行ESD治疗的结直肠黏膜下肿瘤的患者67例,病灶68处,进行回顾性分析。结果?68处病灶中,神经内分泌肿瘤占61.8%,以直肠分布为主,脂肪瘤占29.4%,以结肠分布为主;超声内镜检查46处病灶,位于黏膜下层38处(82.6%),低回声31处(67.4%)。ESD治疗病灶整块切除率100.0%,病理完整切除率94.1%;并发症情况:穿孔发生率6.0%,术后出血发生率1.5%,无1例需外科手术干预;术后随访率95.5%,中位随访时间33个月(3~75个月),未见复发及远处转移。结论?超声内镜有助于结直肠黏膜下肿瘤的诊断,ESD治疗结直肠黏膜下肿瘤安全、有效。
Abstract: Abstract: Objective?To evaluate the outcomes and safety of ESD in colorectal SMTs.?Methods?Between January 2011 and January 2017, we performed ESD on 68 consecutive colorectal SMTs in 67 patients. We evaluated the clinical outcomes of all said cases.?Results?The most common type of the 68 colorectal SMTs was neuroendocrine tumor (42/68, 61.8%), followed by lipoma (20/68, 29.4%). Most of neuroendocrine tumors (41/42) were located in rectum, and most of lipomas (18/20) were located in colon. Among the 46 tumors which were evaluated by endoscopic ultrasonography (EUS) before ESD,38 tumors (82.6%) were located in the submucosal layer, and 31 tumors (67.4%) were hypoecho. Our overall endoscopic en bloc resection rate was 100.0%, and our R0 resection rate was 94.1% respectively. Our perforation rate of ESD was 6.0%, delayed bleeding rate 1.5%. None of the patients need surgical intervention because of complication. Follow-up rate was 95.5%, no recurrence or metastasis was observed during the median follow-up period 33 months (range 3~75 months).?Conclusion?EUS is conductive to the diagnosis of colorectal SMTs before ESD. ESD is a safe and effective treatment for colorectal SMTs.
Chicken soup for teaching and learning ESD
Eun Young Kim,Seong Woo Jeon,Gwang Ha Kim
World Journal of Gastroenterology , 2011, DOI: 10.3748/wjg.v17.i21.2618
Abstract: Endoscopic submucosal dissection (ESD) is becoming a popular procedure for the diagnosis and treatment of superficial mucosal lesions, and has the advantage of en bloc resection which yields a higher complete resection and remission rate compared to endoscopic mucosal resection (EMR). However, the learning process of this advanced endoscopic procedure requires a lengthy training period and considerable experience to be proficient. A well framed training protocol which is safe, effective, easily reproducible and cost-effective is desirable to teach ESD. In addition, the training course may need to be tailored around settings such as ethnicity, culture, workload, and disease incidence. In Asian countries with a large volume of early gastric lesions which need endoscopic treatment, endoscopists would be able to learn ESD expanding their skills from EMR to ESD under the supervision of experts. Whereas, in Western countries due to the low incidence of superficial gastric tumors, trials have utilized simulator models to improve learning. In Korea, the Korean Society of Gastrointestinal Endoscopy (KSGE) is playing an important role in training many gastroenterologists who have shown an interest in performing ESD by providing an annual live demonstration and a nationwide tutoring program. The purpose of this article is to introduce our ESD tutoring experience, review the published papers related to this topic, and propose several suggestions for future directions in teaching and learning ESD.
Management of the complications of endoscopic submucosal dissection
Seong Hwan Kim,Jeong Seop Moon,Young Hoon Youn,Ki Myung Lee
World Journal of Gastroenterology , 2011, DOI: 10.3748/wjg.v17.i31.3575
Abstract: Endoscopic submucosal dissection (ESD) is currently widely accepted as a standard treatment option for early gastrointestinal neoplasms in Korea. However, ESD has technical difficulties and a longer procedure time than conventional endoscopic resection. So it may have a higher risk of complications than conventional endoscopic resection techniques. We, the ESD study group of Korean Society of Gastrointestinal Endoscopy, have experienced many complications, mostly treated by endoscopic or conservative management. Here, we introduce and share our experiences for management of post ESD complications and review published papers on the topic.
Endoscopic Mucosal Resection: Therapy for Early Colorectal Cancer  [PDF]
Kondal R. Kyanam Kabir Baig, Michael B. Wallace
Journal of Cancer Therapy (JCT) , 2013, DOI: 10.4236/jct.2013.41036

We review the use of Endoscopic Mucosal Resection in the treatment of early colorectal cancer. Newer endoscopic imaging modalities have lead to earlier detection of advanced lesions thus enabling endoscopic curative therapy of lesions that would otherwise need surgery. Early outcomes data suggest promising results. But further long term prospective studies are needed.

A Case of Simultaneous Triple Primary Cancers of the Hypopharynx, Esophagus, and Stomach Which Were Dissected by Endoscopic Laryngo-Pharyngeal Surgery Combined with Endoscopic Submucosal Dissection  [PDF]
Kenro Kawada, Taro Sugimoto, Ryuhei Okada, Kazuya Yamaguchi, Yuudai Kawamura, Masafumi Okuda, Yuuichiro Kume, Andres Mora, Tairo Ryotokuji, Takuya Okada, Akihiro Hoshino, Yutaka Tokairin, Yasuaki Nakajima, Yusuke Kiyokawa, Fuminori Nomura, Yoshuke Ariizumi, Shohei Tomii, Takashi Ito, Takahiro Asakage, Yusuke Kinugasa, Tatsuyuki Kawano
Open Journal of Gastroenterology (OJGas) , 2018, DOI: 10.4236/ojgas.2018.83010
Abstract: A 65-year-old man was admitted to our hospital following 6 months of dysphagia. At first, conventional endoscopy showed a reddish and depressed lesion in the stomach and an elevated lesion in the posterior wall of the hypopharynx. An endoscopic biopsy showed adenocarcinoma in the stomach, and squamous cell carcinoma in the hypopharynx. On the further examination, trans-nasal endoscopy with narrow band imaging (NBI) was performed. During the trumpet maneuver, a huge protruded lesion was observed and it reached to the orifice of the esophagus. Other superficial lesion located at left pyriform sinus was detected by NBI system as brownish area with brown dots. Furthermore, superficial esophageal cancer in the cervical esophagus was detected. Finally, 4 carcinomas in upper gastrointestinal tract were detected. Among them, the hypopharyngeal cancer was the most advanced (T3N0). The patient hoped to preserve his voice and swallowing function, endoscopic laryngo-pharyngeal surgery (ELPS) was performed for the hypopharyngeal cancer. Endoscopic mucosal resection (EMR) was performed for the esophageal cancer, and Endoscopic submucosal dissection (ESD) was performed for the gastric cancer. Under collaboration between a head and neck surgeon and an endoscopist, the tumor was resected en-bloc. The histopathological findings of hypopharyngeal cancer were squamous cell carcinoma, subeipthelial invasion, 29 × 28 × 4.2 mm. The others were diagnosed as mucosal cancers. The patient is currently alive with no recurrence at 28 months after the surgery; there is no stricture at the cervical esophagus. Endoscopic laryngopharyngeal surgery for the tumor of pharyngo-esophageal junction can provide a less invasive treatment.
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