Gut Liver.  2012 Jan;6(1):58-63.

The Feasibility and Safety of the Endoscopic Submucosal Dissection of Superficial Gastric Neoplastic Lesions in Patients with Compensated Liver Cirrhosis: A Retrospective Study

• Choi JH
• Kim ER
• Min BH
• Choi D
• Kang KJ
• Lee JH
• Rhee PL
• Kim JJ
• Rhee JC

Abstract

BACKGROUND/AIMS
When undergoing endoscopic submucosal dissection (ESD), patients with liver cirrhosis (LC) may suffer from a high risk of bleeding, bacteremia and tissue vulnerability. There have been few reports evaluating the efficacy and safety of ESD in patients with LC.
METHODS
From January 2004 to March 2010, 23 patients with LC (cirrhosis group) underwent ESD for superficial gastric neoplastic lesions. The number of patients with a liver function in the Child-Pugh classes A and B were 20 and 3, respectively. The clinical outcomes and complications were compared with 69 patients without LC (control group) that were matched for age and sex.
RESULTS
The en bloc resection, R0 resection and en bloc plus R0 resection rates of the cirrhosis group were 82.6%, 91.3%, and 82.6%, respectively, and did not show significant differences from the rates of the control group. No local recurrence was found in either group during the follow-up period. The procedure length of time (41.0 vs 39.0 minutes), rate of bleeding (4.3% vs 7.2%) and rate of perforation (0.0% vs 1.4%) in the cirrhosis group were also comparable to the results from the control group.
CONCLUSIONS
ESD was safely performed in patients with LC, and satisfactory outcomes were achieved with high en bloc and R0 resection rates for superficial gastric neoplastic lesions.

Keyword

Superficial gastric neoplastic lesion; Endoscopic submucosal dissection; Liver cirrhosis

MeSH Terms

Bacteremia
Fibrosis
Follow-Up Studies
Hemorrhage
Humans
Liver
Liver Cirrhosis
Recurrence
Retrospective Studies