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The impact of experience on short- and long-term outcomes on gastric ESD: a western series

  • F. Catalano
  • V. MengardoEmail author
  • A. Trecca
  • A. Tomezzoli
  • L. Rodella
  • A. Cerofolini
  • G. Verlato
  • G. de Manzoni
Original Article
  • 7 Downloads

Abstract

Endoscopic submucosal dissection (ESD) represents the standard of care for early gastric cancer in Eastern countries. Nevertheless, in the West, this procedure is not widespread. Aim of the study was to confirm the feasibility and the efficacy of ESD in the West. A total of 60 ESD were performed between January 2005 and December 2014 by two expert endoscopists. The analysis, based on a retrospective collected database, was conducted by dividing the study period in three subgroups. Clinical and technical outcomes have been compared. Rates of complete, curative and en bloc resection did not significantly change among the study periods. Three cases of perforation occurred (5%), one in each period. The operation time significantly decreased from the second to the third period (p < 0.001). When adjusting for gender, tumor size and site in multivariable analysis, operation time decreased by nearly 90 min from the first to the second period, and by more than 3 h from the first to the last period. The median follow-up was 33 months. No cases of local or lymphnodal recurrence were detected during the study period. One patient presented a synchronous lesion, whilst four metachronous lesions have been discovered after a median follow-up of 11 months. Our experience supports the feasibility and safety of ESD in the West, if an adequate learning curve is accomplished. Long-term outcomes are comparable to the Eastern series.

Keywords

ESD Gastric cancer Early gastric cancer Western experience 

Notes

Acknowledgements

None.

Compliance with ethical standards

Conflict of interest

The authors have no conflict of interest to declare.

Research involving human participants and/or animals

The present manuscript is in compliant with ethical standard. This article does not contain any studies with animals performed by any of the authors.

Informed consent

All patients gave informed consent to the procedure and patients anonymity was preserved.

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Copyright information

© Italian Society of Surgery (SIC) 2019

Authors and Affiliations

  • F. Catalano
    • 1
  • V. Mengardo
    • 2
    Email author
  • A. Trecca
    • 3
  • A. Tomezzoli
    • 4
  • L. Rodella
    • 1
  • A. Cerofolini
    • 1
  • G. Verlato
    • 5
  • G. de Manzoni
    • 2
  1. 1.Department of Emergency Surgical EndoscopyBorgo Trento HospitalVeronaItaly
  2. 2.General and Upper GI Surgery DivisionUniversity of VeronaVeronaItaly
  3. 3.Operative Units of EndoscopyUsi GroupRomeItaly
  4. 4.Department of PathologyBorgo Trento HospitalVeronaItaly
  5. 5.Department of Diagnostics and Public HealthUniversity of VeronaVeronaItaly

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