Non-cardia early gastric cancer in Central Vietnam: noticeable uncommon background mucosa and results of endoscopic submucosal dissection

医学 内镜黏膜下剥离术 穿孔 胃肠病学 恶性肿瘤 彩色内窥镜 内科学 粘膜切除术 内窥镜检查 癌症 入射(几何) 萎缩性胃炎 解剖(医学) 外科 胃炎 结肠镜检查 冶金 结直肠癌 材料科学 冲孔 物理 光学
作者
Van Huy Tran,Quang Trung Tran,Thi Huyen Thuong Nguyen,Cong Thuan Dang,Markus M. Lerch,Ali A. Aghdassi,Ryoji Miayahara
出处
期刊:Endoscopy International Open [Thieme Medical Publishers (Germany)]
卷期号:10 (08): E1029-E1036 被引量:1
标识
DOI:10.1055/a-1854-4587
摘要

Abstract Background and study aims Gastric cancer (GC) is one of the leading causes of malignancy-related death in Vietnam, with increasing incidence of non-cardia early gastric cancer (N-EGC). Data on accurate diagnosis of EGC and treatment by endoscopic submucosal dissection (ESD) in Vietnam are very sparse. The aim of this study was to describe the characteristics of N-EGC and evaluate the effectiveness and the safety of ESD in Central Vietnam. Patients and methods We prospectively enrolled patients with N-EGC detected by magnified chromoendoscopy from December 2013 to August, 2018 in Central Vietnam. Selected cases of N-EGC received standardized ESD technique and have been following up carefully as in protocol. Results Among 606 GC patients, 46 had N-GEC and underwent ESD. The depth of invasion was pT1a in 33 (71.7 %), pT1b1 in 10 (21.7 %), and pT1b2 in three cases (6.6 %). Mild chronic atrophic gastritis, most being C2 (63 %), and gastritis-like EGC that did not appear malignant was the predominant type. ESD achieved a 97.8 % en bloc resection rate; the mean procedure time was 76 ± 22 minutes (range 24–155), and mean endoscopic tumor size was 23 ± 5 mm (range 13–52) and ESD sample size was 28 ± 7 mm (range 16.5–60). Complications consisted of two patients with bleeding and one with a minor perforation, all of which were successfully managed by endoscopy. The longest and the mean follow-up times were 84 and 64 months, respectively, with no recurrence. Conclusions A significant proportion patients with N-EGC have a background mucosa of mild chronic atrophic gastritis. Our results 7 years after starting ESD demonstrate early promising outcomes with the procedure.
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