Korean J Helicobacter Up Gastrointest Res.  2014 Sep;14(3):174-180. 10.7704/kjhugr.2014.14.3.174.

Feasibility of Planned Endoscopic Submucosal Dissection with Snaring for Gastric Adenoma Compared with Standard Endoscopic Submucosal Dissection

• Jang GH
• Kim HH
• Ahn SY

• KMID: 2305137
• DOI: http://doi.org/10.7704/kjhugr.2014.14.3.174

Abstract

BACKGROUND/AIMS
Planned endoscopic submucosal dissection with snaring (ESD-S) is thought to shorten operating time spent on submucosal dissection, but may lead to uncertainty of en bloc resection or to a possible increase in tumor-positive margins. The purpose of the present study is to investigate the feasibility of ESD-S as a planned procedure for gastric adenoma.
MATERIALS AND METHODS
The medical records of 99 patients who underwent ESD-S or ESD for gastric adenoma between May 2011 and May 2012 were retrospectively reviewed. We analyzed the differences between the ESD-S and the ESD groups, focusing on rates of en bloc resection and pathologic complete resection, mean operation time, and complications.
RESULTS
The mean operation time was significantly lower in the ESD-S group than in the ESD group (19.9+/-11.2 vs. 33.8+/-19.9, P=0.012). Cases with an operation time under 30 minutes were more frequent in the ESD-S group (88.9% vs. 48.1%, OR=8.615, 95% CI=2.949~25.168). There were no significant differences in en bloc resection, histologic complete resection, or complication rates between the two groups.
CONCLUSIONS
ESD-S has a time advantage over ESD with a comparable compete resection rate. ESD-S can be considered a planned method for available early gastric adenoma.

Keyword

Endoscopy; Treatment; Time

MeSH Terms

Adenoma*
Endoscopy
Focus Groups
Humans
Medical Records
Retrospective Studies
SNARE Proteins*
Uncertainty
SNARE Proteins