J Cancer 2021; 12(3):765-770. doi:10.7150/jca.47653

Research Paper

Comparison of Endoscopic Submucosal Dissection Application on Mucosal Tumor and Subepithelial Tumor in stomach

Wen-Hung Hsu1,2, Tzung-Shiun Wu3, Meng-Shu Hsieh1, Yu-Min Kung4, Yao-Kuang Wang1,2, Jeng-Yih Wu1,2, Fang-Jung Yu1,2, Chao-Hung Kuo2,4, Yu-Chung Su1,2, Jaw-Yuan Wang5, Deng-Chyang Wu1,2, Huang-Ming Hu2,3✉

1. Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
2. Department of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
3. Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan.
4. Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan.
5. Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.

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Citation:
Hsu WH, Wu TS, Hsieh MS, Kung YM, Wang YK, Wu JY, Yu FJ, Kuo CH, Su YC, Wang JY, Wu DC, Hu HM. Comparison of Endoscopic Submucosal Dissection Application on Mucosal Tumor and Subepithelial Tumor in stomach. J Cancer 2021; 12(3):765-770. doi:10.7150/jca.47653. Available from https://www.jcancer.org/v12p0765.htm

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Abstract

Background: Endoscopic submucosal dissection is minimal invasive endoscopic procedure to deal with gastric tumor. Initially, it was developed to resect mucosal neoplasm since 2000 and extended its application to submucosal tumor in the following years. Although the basic ESD skills are similar in gastric mucosal tumor and subepithelial tumor, the success rate, complication may be different between the two types of gastric tumor resection. This retrospective study is conducted to analyze the ESD procedure in gastric mucosal tumor and subepithelial tumor.

Methods: From 2007 to 2016, we reviewed all patients who underwent endoscopic submucosal dissection for gastric mucosal tumor and subepithelial tumor in Kaohsiung Medical University Hospital.

Results: Totally, 35 patients with gastric subepithelial tumor and 41 patients with gastric mucosal tumor received endoscopic submucosal dissection are enrolled. Among 35 patients with subepithelial tumor, 32 (91.4%) patients achieved curative treatment. 1 patient received emergent operation and 2 patients received salvage operation to complete tumor resection. 8 patients (22.9%) occurred perforation and no delay bleeding was found. Among 41 patients with mucosal neoplasm, 30 (71.4%) patients achieved curative treatment. 2 patients received emergent operation and 9 patients received salvage operation to complete tumor resection. 9 patients (21.9%) occurred complication, 6 patients occurred delay bleeding and 3 patients had perforation.

Conclusions: Comparing ESD between gastric mucosal tumor and subepithelial tumor, ESD had similar efficiency in curative treatment. However, ESD in subepethelial tumor encountered higher perforation and lesser delay bleeding.

Keywords: endoscopic submucosal dissection (ESD), gastric subepithelial tumor (SET)