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Korean J Gastrointest Endosc. 2009 Aug;39(2):78-84. Korean. Original Article.
Lee CK , Chung IK , Cho JY , Kim JJ , Chun HJ , Jeong HY , Seol SY .
Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea.
Department of Internal Medicine, Sungkyunkwan University School of Medicine, Korea.
Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
Department of Internal Medicine, Chungnam National Unversity College of Medicine, Daejon, Korea.
Department of Internal Medicine, Inje University College of Medicine, Busan, Korea

BACKGROUND/AIMS: Endoscopic submucosal dissection (ESD) has become a widely accepted method for treating early gastric cancer (EGC) in Korea. However, there is not an established guideline for indications of ESD. The objective of this study was to assess the current status and practice patterns regarding indications for ESD in Korea. METHODS: A 17-item questionnaire about indications for ESD in EGC was presented to the participants of the 2nd joint symposium of the Gastrointestinal Pathology Study Group of the Korean Society of pathologists. Keypad-based anonymous voting was carried out and the entire process was recorded. RESULTS: Endoscopic submucosal dissection for EGC fulfilling the classical indications was widely accepted as an effective therapeutic strategy comparable to surgery (114/115, agreement 99.5%). In our survey, Japanese extended criteria for ESD was still debated (70/111, 63.6%), but most respondents had performed ESD selectively in EGC corresponding to the extended criteria (105/109, 96.3%). They agreed that the current criteria for ESD would possibly require a revision considering various clinical indicators. CONCLUSIONS: Our survey shows that there is still no consensus about indications for ESD in EGC. Therefore, more clinical outcome data with a long-term follow-up are needed to establish evidence-based consensus and guidelines for ESD indications in Korea. (

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