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Short- and long-term outcomes of endoscopic submucosal dissection for early gastric cancer in the remnant stomach after gastrectomy

  • Original Article—Alimentary Tract
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Abstract

Background

Endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) in the remnant stomach is a minimally invasive treatment. Few studies compared the technical difficulty of ESD involving the suture line and anastomosis, and information on long-term outcomes is insufficient. This study aimed to elucidate the short- and long-term outcomes of ESD for EGC in the remnant stomach.

Methods

We investigated patients who underwent ESD for EGC in the remnant stomach between September 2002 and March 2016. Clinicopathological data were retrieved to assess en bloc resection rates, complications, and long-term outcomes including overall survival and cause-specific survival.

Results

A total of 136 consecutive patients with 165 lesions resected by 157 ESD procedures were retrospectively evaluated. The en bloc resection rate was 95.5%. Complications included 16 intraoperative perforations (10.2%), 2 delayed perforations (1.3%), and 15 delayed bleeding (9.6%), which were successfully treated with endoscopy. The en bloc resection rate was significantly higher in the suture line group (100%) and the non-anastomosis or suture line group (98.8%) than in the anastomosis group (82.9%). However, the intraoperative perforation rate was significantly higher in the anastomosis group (31.4%) than in other groups. The 5-year overall and cause-specific survival rates were 88.4% and 97.6%, respectively, during a median follow-up period of 50.7 months (interquartile range 30.8–91.3).

Conclusions

The long-term outcomes of ESD for EGC in the remnant stomach were favorable. However, ESD involving the anastomosis was a technically demanding procedure due to the low en bloc resection rate and high perforation rate.

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Acknowledgements

We thank all members of the Division of Endoscopy, Shizuoka Cancer Center, for help rendered with this study.

Funding

The authors received no specific funding for this work.

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Authors and Affiliations

  1. Division of Endoscopy, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi, Suntogun, Shizuoka, 411-8777, Japan

    Yohei Yabuuchi, Naomi Kakushima, Kohei Takizawa, Masaki Tanaka, Noboru Kawata, Masao Yoshida, Yoshihiro Kishida, Sayo Ito, Kenichiro Imai, Hirotoshi Ishiwatari, Kinichi Hotta, Hiroyuki Matsubayashi & Hiroyuki Ono

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  1. Yohei Yabuuchi
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  2. Naomi Kakushima
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  3. Kohei Takizawa
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Correspondence to Naomi Kakushima.

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Yabuuchi, Y., Kakushima, N., Takizawa, K. et al. Short- and long-term outcomes of endoscopic submucosal dissection for early gastric cancer in the remnant stomach after gastrectomy. J Gastroenterol 54, 511–520 (2019). https://doi.org/10.1007/s00535-018-1528-1

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  • DOI: https://doi.org/10.1007/s00535-018-1528-1

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