Endoscopic submucosal dissection of neoplasms and early cancers in the upper gastrointestinal tract – Efficacy and safety of ESD in a non-academic center

2016 ◽  
Vol 54 (05) ◽  
Author(s):  
V Winna ◽  
M Wappl ◽  
M Häfner
Keyword(s):  
Gastrointestinal Tract ◽  
Endoscopic Submucosal Dissection ◽  
Upper Gastrointestinal Tract ◽  
Efficacy And Safety ◽  
Submucosal Dissection ◽  
Academic Center ◽  
Upper Gastrointestinal

scholarly journals Pilot Study of Acupuncture’s Antispasmodic Effect on Upper Gastrointestinal Tract during Endoscopic Submucosal Dissection for Early Gastric Cancer: Controlled Clinical Trial

2021 ◽  
Vol 10 (14) ◽  
pp. 3050
Author(s):  
Masao Suzuki ◽  
Naoto Ishizaki ◽  
Takumi Kayo ◽  
Taiga Furuta ◽  
Ryo Igarashi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Gastrointestinal Tract ◽  
Endoscopic Submucosal Dissection ◽  
Controlled Trial ◽  
Upper Gastrointestinal Tract ◽  
Controlled Clinical Trial ◽  
Whitney Test ◽  
Submucosal Dissection ◽  
Mann Whitney Test ◽  
Upper Gastrointestinal

A prospective study was conducted in patients with early-stage gastric cancer to determine the efficacy and safety of acupuncture stimulation as an antispasmodic compared with conventional medication during the procedure of endoscopic submucosal dissection (ESD) of the upper gastrointestinal tract. This study was a prospective single blinded quasi-randomized controlled trial. Seventy-three patients who were scheduled to undergo ESD for gastric cancer at Aizu Medical Center between 19 February 2016 and 30 June 2016 were assessed for eligibility for the study. Sixty out of 73 patients were included in the study and assigned into two intervention groups: medication group (MG) and acupuncture group (AG). Ease of the procedure was evaluated using modified NIWA classification (MNC) by endoscopist considering the frequency and amplitude of the upper gastrointestinal peristalsis. For the statistical analysis, Mann–Whitney test was used to compare the differences of MNC values (baseline and end of procedure) between two groups. The difference of MNC found in the AG (−2.00 (−3.0 to −2.0)) was significantly greater than that in the MG (−1.00 (−2.0 to −1.0), p < 0.0001, Mann–Whitney test). We consider that acupuncture to the abdomen could be an alternative antispasmodic method during upper gastrointestinal endoscopic procedure.

scholarly journals Implementation of endoscopic submucosal dissection for early upper gastrointestinal tract cancer after primary experience in colorectal endoscopic submucosal dissection

2019 ◽  
Vol 07 (04) ◽  
pp. E446-E451 ◽  
Author(s):  
Lena Mocker ◽  
Ralf Hildenbrand ◽  
Tsuneo Oyama ◽  
Bernd Sido ◽  
Naohisa Yahagi ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Endoscopic Submucosal Dissection ◽  
Curative Resection ◽  
Case Series ◽  
Upper Gastrointestinal Tract ◽  
Western World ◽  
Minimal Risk ◽  
Retrospective Case ◽  
Submucosal Dissection ◽  
Upper Gastrointestinal

Abstract Background Current guidelines recommend endoscopic submucosal dissection (ESD) as a treatment option for early cancers of the upper gastrointestinal tract with absent or minimal risk of lymph node metastasis. However, due to the low prevalence of these entities, it is difficult to achieve a competence level for ESD of upper gastrointestinal tract cancers in the Western World. Here, we present single-center data on the implementation of upper gastrointestinal ESD after previous experience with 89 colorectal ESD cases. Methods Retrospective case series of 39 consecutive patients with early cancers of the esophagus (n = 13) or cardia and stomach (n = 26) treated with ESD over a 4-year period. Results ESD was technically feasible in all cases with en bloc, R0, and curative resection rates of 100 %, 76.9 %, and 71.8 %, respectively, and a mean procedure time of 100 minutes (30 – 360 minutes). After an initial 20 procedures, the R0 and curative resection rates increased from 65.0 % to 89.5 %, and from 60.0 % to 84.2 %, respectively. Complications were observed in four patients (10.3 %): three perforations, one case of delayed bleeding, and one esophageal stricture. No case required emergency surgery; the 30-day mortality rate was 0 %. Conclusion In this modest case series from Europe, we observed an effectiveness and complication rate for ESD for early esophageal and gastric cancer that are comparable to other series from Europe but also to more abundant data from Asia. The results indicate that even small numbers of upper gastrointestinal cancers can be managed adequately in centers with expertise in colorectal ESD.

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