RSS-Feed abonnieren
DOI: 10.1055/s-2007-995650
© Georg Thieme Verlag KG Stuttgart · New York
Efficacy and safety of endoscopic submucosal dissection for gastric cancer in patients with liver cirrhosis
Publikationsverlauf
submitted 21 September 2007
accepted after revision 11 February 2008
Publikationsdatum:
02. April 2008 (online)
Endoscopic submucosal dissection (ESD) has become a widely accepted method for treating gastrointestinal cancer. The aim of this study was to evaluate the efficacy and safety of ESD for gastric cancer in patients with liver cirrhosis. A total of 18 gastric cancers were treated by ESD in 15 patients with cirrhosis. The rate of en bloc resection was 88.9 % (16/18). En bloc resection with tumor-free lateral/basal margins (R0 resection) was 77.8 % (14/18). Three patients had postoperative bleeding and underwent emergency gastroscopy for hemostasis. No recurrence was observed during the median follow-up of 21.4 months, excluding three patients in whom additional endoscopic resection or surgery was carried out. ESD can be safely performed for gastric cancer in patients with cirrhosis, resulting in a high en bloc resection rate.
References
- 1 Oka S, Tanaka S, Kaneko I. et al . Advantage of endoscopic submucosal dissection compared with EMR for early gastric cancer. Gastrointest Endosc. 2006; 64 877-883
- 2 Kakushima N, Fujishiro M, Kodashima S. et al . A learning curve for endoscopic submucosal dissection of gastric epithelial neoplasms. Endoscopy. 2006; 38 991-995
- 3 Mansour A, Watson W, Shayani V. et al . Abdominal operations in patients with cirrhosis: still a major surgical challenge. Surgery. 1997; 122 730-735
- 4 Kakushima N, Fujishiro M, Kodashima S. et al . Histopathologic characteristics of gastric ulcers created by endoscopic submucosal dissection. Endoscopy. 2006; 38 412-415
- 5 Participants in the Paris Workshop . The Paris endoscopic classification of superficial neoplastic lesions: esophagus, stomach, and colon. Gastrointest Endosc. 2003; 58 S3-S43
- 6 Dixon M F. Gastrointestinal epithelial neoplasia: Vienna revisited. Gut. 2002; 51 130-131
- 7 Japanese Gastric Cancer Association . Japanese classification of gastric carcinoma - 2nd English Edition. Gastric Cancer. 1998; 1 10-24
- 8 Sano T, Sasako M, Kinoshita T. et al . Recurrence of early gastric cancer. Follow-up of 1475 patients and review of the Japanese literature. Cancer. 1993; 72 3174-3178
- 9 Isozaki H, Okajima K, Ichinona T. et al . Surgery for gastric cancer in patients with cirrhosis. Surg Today. 1997; 27 17-21
- 10 Ryu K W, Lee J H, Kim Y W. et al . Management of ascites after radical surgery in gastric cancer patients with liver cirrhosis and minimal hepatic dysfunction. World J Surg. 2005; 29 653-656
- 11 Lee J H, Kim J, Cheong J H. et al . Gastric cancer surgery in cirrhotic patients: result of gastrectomy with D2 lymph node dissection. World J Gastroenterol. 2005; 11 4623-4627
K. Ogura, MD, PhD
Department of Gastroenterology
University of Tokyo Graduate School of Medicine
7-3-1 Hongo
Bunkyo
Tokyo 113-8655
Japan
Fax: + 81-3-3814-0021
eMail: keiji-tky@umin.ac.jp