Korean J Helicobacter Up Gastrointest Res.  2021 Mar;21(1):72-81. 10.7704/kjhugr.2020.0047.

Atypical Scar Patterns after Gastric Endoscopic Submucosal Dissection

• Kim B
• Kim BJ
• Yoon HJ
• Lee H
• Park JY
• Choi CH
• Kim JG

• KMID: 2513962
• DOI: http://doi.org/10.7704/kjhugr.2020.0047

Abstract

Background/Aims
Endoscopic submucosal dissection (ESD) for gastric neoplasms is a widely performed procedure. Local recurrence is rare, but various post-ESD scars are encountered during follow-up endoscopy. Therefore, we investigated atypical scar patterns and evaluated the associated factors.
Materials and Methods
Clinicopathologic and endoscopic reviews of gastric neoplasms treated with ESD from January 2009 to December 2015 were conducted. Atypical scar patterns were classified as irregular erythema, nodularity, or mucosal defect.
Results
A total of 264 patients with 274 gastric neoplasms, including 201 adenomas and 73 early gastric cancers, were enrolled. The key endoscopic findings at the resection scar were defined on the basis of gross morphology as follows: irregular erythema, mucosal defect (erosion or ulcer), and nodularity. An irregular erythema scar pattern was associated with male sex, a nodularity scar pattern with smoking, and a mucosal defect scar pattern with infra-angle location (angle and antrum) and cancer. An irregular erythema with nodularity scar pattern was also associated with male sex. An irregular erythema with nodularity and mucosal defect scar pattern was associated with liver disease and chronic kidney disease.
Conclusions
The atypical scar patterns after gastric ESD are associated with various clinicopathologic factors.

Keyword

Endoscopic submucosal dissection; Scar; Stomach neoplasms