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Surgical Endoscopy

, Volume 32, Issue 8, pp 3622–3629 | Cite as

Endoscopic submucosal dissection for early gastric cancer on the lesser curvature in upper third of the stomach is a risk factor for postoperative delayed gastric emptying

  • Tetsuya Yoshizaki
  • Daisuke Obata
  • Yasuhiro Aoki
  • Norihiro Okamoto
  • Hiroki Hashimura
  • Chise Kano
  • Megumi Matsushita
  • Atsushi Kanamori
  • Kei Matsumoto
  • Masahiro Tsujimae
  • Kenji Momose
  • Takaaki Eguchi
  • Shunsuke Okuyama
  • Hiroshi Yamashita
  • Mikio Fujita
  • Akihiko Okada
Article

Abstract

Background

Advances in Endoscopic submucosal dissection (ESD) technology have established ESD for early gastric cancer as a safe and stable technique. However, ESD may induce delayed gastric emptying and the cause of food residue retention in the stomach after ESD is not clear. This study aimed to clarify risk factors for delayed gastric emptying with food retention after gastric ESD.

Methods

We retrospectively examined for food residue in the stomach 1 week after ESD was performed for early gastric carcinoma at Osaka Saiseikai Nakatsu Hospital from February 2008 to November 2016.

Results

Food residue was observed in 68 (6.1%) of 1114 patients who underwent gastric ESD. The percentage of lesions located on the lesser curvature of the upper third of the stomach was 45.6% (31/68) in the food residue group and 3.5% (37/1046) in the non-food residue group, which was significantly different (P < 0.01). Multivariate logistic regression analysis revealed that lesions on the lesser curvature of the upper third of the stomach (Odds ratio [OR] 23.31, 95% confidence interval [CI] 12.60–43.61, P < 0.01), post-ESD bleeding (OR 4.25, 95%CI 1.67–9.80, P < 0.01), submucosal invasion (OR 2.80, 95%CI 1.34–5.63, P < 0.01), and age over 80 years (OR 2.34, 95%CI 1.28–4.22, P < 0.01) were independent risk factors for food retention after gastric ESD. Of the 68 patients, 3 had food residue in the stomach on endoscopic examination for follow-up observation after the ESD ulcer had healed.

Conclusions

Delayed gastric emptying with food retention after gastric ESD was associated with lesions located in the lesser curvature of the upper stomach, submucosal invasion of the lesion, age older than 80 years, and post-ESD bleeding, though it was temporary in most cases.

Keywords

Endoscopic submucosal dissection Gastric emptying Food residue Lesser curvature Post-ESD bleeding Submucosal invasion 

Notes

Acknowledgements

The authors wish to thank Dr. Yoshiko Ohara and Dr. Daisuke Watanabe at Kobe University Hospital for refining our manuscript.

Compliance with ethical standards

Disclosures

Tetsuya Yoshizaki, Daisuke Obata, Yasuhiro Aoki, Norihiro Okamoto, Hiroki Hashimura, Chise Kano, Megumi Matsushita, Atsushi Kanamori, Kei Matsumoto, Masahiro Tsujimae, Kenji Momose, Takaaki Eguchi, Shunsuke Okuyama, Hiroshi Yamashita, Mikio Fujita, Akihiko Okada have no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Tetsuya Yoshizaki
    • 1
  • Daisuke Obata
    • 1
  • Yasuhiro Aoki
    • 1
  • Norihiro Okamoto
    • 1
  • Hiroki Hashimura
    • 1
  • Chise Kano
    • 1
  • Megumi Matsushita
    • 1
  • Atsushi Kanamori
    • 1
  • Kei Matsumoto
    • 1
  • Masahiro Tsujimae
    • 1
  • Kenji Momose
    • 1
  • Takaaki Eguchi
    • 1
  • Shunsuke Okuyama
    • 1
  • Hiroshi Yamashita
    • 1
  • Mikio Fujita
    • 1
  • Akihiko Okada
    • 1
  1. 1.Department of GastroenterologySaiseikai Nakatsu HospitalOsakaJapan

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