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Clinical outcomes of double endoscopic intralumenal surgery for early gastric cancer

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Abstract

Background

Endoscopic submucosal dissection (ESD) is a safe, efficacious, and minimally invasive technique for superficial gastrointestinal neoplasms. However, the procedure is long, complex, and associated with higher complication rates. To overcome such limitations, the authors devised a double endoscopic intralumenal operation (DEILO) and assessed its efficacy and safety for superficial gastric neoplasms.

Methods

The DEILO procedure was performed for 31 gastric cancers. This novel technique is characterized by the use of two endoscopes, one for lifting lesions and the other for cutting them, inserted into the stomach simultaneously.

Results

The DEILO technique was performed successfully, and en bloc resection was achieved for 29 (93.5%) of 31 patients. Histologically, curative resection was achieved for 26 lesions (83.8%). The mean operating time for DEILO was 34 min (range, 20–107 min). Two patients experienced postoperative hemorrhage, which was controlled endoscopically. Perforation occurred in two cases (6.4%), both of which were successfully treated nonsurgically.

Conclusion

The DEILO procedure appears to shorten the operating time for ESD, with comparable efficacy and complication rates.

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References

  1. Gotoda T (2005) A large endoscopic resection by endoscopic submucosal dissection (ESD) procedure. Clin Gastroenterol Hepatol 3:71–73

    Article  Google Scholar 

  2. Gotoda T, Yamamoto H, Soetikno RM (2006) Endoscopic submucosal dissection of early gastric cancer. J Gastroenterol 41:929–942

    Article  PubMed  Google Scholar 

  3. Gotoda T, Yanagisawa A, Sasako M, Ono H, Nakanishi Y, Shimoda T, Kato Y (2000) Incidence of lymph node metastasis from early gastric cancer: estimation with a large number of cases at two large centers. Gastric Cancer 3:219–225

    Article  PubMed  Google Scholar 

  4. Ono H, Kondo H, Gotoda T, Shirao K, Yamaguchi H, Saito D, Hosokawa K, Shimoda T, Yoshida S (2001) Endoscopic mucosal resection for treatment of early gastric cancer. Gut 48:225–229

    Article  CAS  PubMed  Google Scholar 

  5. Ono H, Hasuike N, Inui T, Takizawa K, Ikehara H, Yamaguchi Y, Otake Y, Matsubayashi H (2008) Usefulness of a novel electrosurgical knife, the insulation-tipped diathermic knife-2, for endoscopic submucosal dissection of early gastric cancer. Gastric cancer 11:47–52

    Article  PubMed  Google Scholar 

  6. Kuwano H, Mochiki E, Asao T, Kato H, Shimura T, Tsutsumi S (2004) Double endoscopic intralumenal operation for upper digestive tract diseases: proposal of a novel procedure. Ann Surg 239:22–27

    Article  PubMed  Google Scholar 

  7. Japanese Gastric Cancer Society (2004) Guidelines for diagnosis and treatment of carcinoma of the stomach, April 2004 edn. Kanehara, Tokyo

    Google Scholar 

  8. Japanese Gastric Cancer Society (1998) Japanese classification of gastric carcinoma. 2nd English edn. Gastric Cancer 1:10–24

    Article  Google Scholar 

  9. Gotoda T (2007) Endoscopic resection of early gastric cancer. Gastric Cancer 10:1–11

    Article  PubMed  Google Scholar 

  10. Saito Y, Emura F, Matsuda T (2005) A new sinker-assisted endoscopic submucosal dissection for colorectal cancer. Gastrointest Endosc 62:297–301

    Article  PubMed  Google Scholar 

  11. Kondo H, Gotoda T, Ono H, Oda I, Kozu T, Fujishiro M, Saito D, Yoshida S (2004) Percutaneous traction-assisted EMR by using an insulation-tipped electrosurgical knife for early-stage gastric cancer. Gastrointest Endosc 59:284–288

    Article  PubMed  Google Scholar 

  12. Kobayashi T, Gotohda T, Tamakawa K, Ueda H, Kakizoe T (2004) Magnetic anchor for more effective endoscopic mucosal resection. Jpn J Clin Oncol 34:118–123

    Article  PubMed  Google Scholar 

  13. Imaeda H, Iwao Y, Ogata H, Ichikawa H, Mori M, Hosoe N, Masaoka T, Nakashita M, Suzuki H, Inoue N, Aiura K, Nagata H, Kumai K, Hibi T (2006) A new technique for endoscopic submucosal dissection for early gastric cancer using an external grasping forceps. Endoscopy 38:1007–1010

    Article  CAS  PubMed  Google Scholar 

  14. Chen PJ, Chu HC, Chang WK, Hsieh TY, Chao YC (2008) Endoscopic submucosal dissection with internal traction for early gastric cancer. Gastointest Endosc 67:128–132

    Article  Google Scholar 

  15. Shimura T, Sasaki M, Kataoka H, Tanida S, Oshima T, Ogasawara N, Wada T, Kubota E, Yamada T, Mori Y, Fujita F, Nakao H, Ohara H, Inukai M, Kasugai K, Joh T (2007) Advantages of endoscopic submucosal dissection over conventional endoscopic mucosal resection. J Gastroenterol Hepatol 22:821–826

    Article  PubMed  Google Scholar 

  16. Oka S, Tanaka S, Kaneko I, Mouri R, Hirata M, Kawamura T, Yoshihara M, Chayama K (2006) Advantage of endoscopic submucosal dissection compared with EMR for early gastric cancer. Gastrointest Endosc 64:877–883

    Article  PubMed  Google Scholar 

  17. Goto O, Fujishiro M, Kodashima S, Ono S, Omata M (2009) Is it possible to predict the procedural time of endoscopic submucosal dissection for early gastric cancer? J Gastroenterol Hepatol 24:379–383

    Article  PubMed  Google Scholar 

  18. ASGE Technology Committee, Kantsevoy SV, Adler DG, Conway JD, Diehl DL, Farraye FA, Kwon R, Mamula P, Rodriguez S, Shah RJ, Wong Kee Song LM, Tierney WM (2008) Endoscopic mucosal resection and endoscopic submucosal dissection. Gastrointest Endosc 68:11–18

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of General Surgical Science, Faculty of Medicine, Gunma University, 3-39-15, Showa-machi, Maebashi, 371-8511, Japan

    Erito Mochiki, Mitsuhiro Yanai, Yoshitaka Toyomasu, Kyouichi Ogata, Hiroyuki Andoh, Tetsuro Ohno, Ryusuke Aihara, Takayuki Asao & Hiroyuki Kuwano

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  1. Erito Mochiki
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  2. Mitsuhiro Yanai
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  3. Yoshitaka Toyomasu
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  4. Kyouichi Ogata
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  5. Hiroyuki Andoh
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  6. Tetsuro Ohno
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  7. Ryusuke Aihara
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  8. Takayuki Asao
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  9. Hiroyuki Kuwano
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Correspondence to Erito Mochiki.

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Mochiki, E., Yanai, M., Toyomasu, Y. et al. Clinical outcomes of double endoscopic intralumenal surgery for early gastric cancer. Surg Endosc 24, 631–636 (2010). https://doi.org/10.1007/s00464-009-0666-1

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  • DOI: https://doi.org/10.1007/s00464-009-0666-1

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