Endoscopic submucosal tunnel dissection salvage technique for ulcerative early gastric cancer

作     者：Hyuk Soon Choi Hoon Jai Chun Min Ho Seo Eun Sun Kim Bora Keum Yeon Seok Seo Yoon Tae Jeen Hong Sik Lee Soon Ho Um Chang Duck Kim Ho Sang Ryu 

作者机构：Division of Gastroenterology and HepatologyDepartment of Internal MedicineInstitute of Digestive Disease and NutritionKorea University College of Medicine 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2014年第20卷第27期

页      面：9210-9214页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：Supported by Korea Healthcare Technology R and D Project,Ministry of Health and Welfare,South Korea,No.A111182 A grant from Korea University 

主　　题：Endoscopy Early gastric cancer Endoscopic submucos 

摘      要：Endoscopic submucosal dissection is an effective treatment modality for early gastric cancer(EGC), though the submucosal fibrosis found in ulcerative EGC is an obstacle for successful treatment. This report presents two cases of ulcerative EGC in two males, 73- and 80-year-old, with severe fibrosis. As endoscopic ultrasonography suggested that the EGCs had invaded the submucosal layer, the endoscopic submucosal tunnel dissection salvage technique was utilized for complete resection of the lesions. Although surgical gastrectomy was originally scheduled, the two patients had severe coronary heart disease, and surgeries were refused because of the risks associated with their heart conditions. The endoscopic submucosal tunnel dissection salvage technique procedures described in these cases were performed under conscious sedation, and were completed within 30 min. The complete en bloc resection of EGC using endoscopic submucosal tunnel dissection salvage technique was possible with a free resection margin, and no other complications were noted during the procedure. This is the first known report concerning the use of the endoscopic submucosal tunnel dissection salvage technique salvage technique for treatment of ulcerative EGC. We demonstrate that endoscopic submucosal tunnel dissection salvage technique it is a feasible method showing several advantages over endoscopic submucosal dissection for cases of EGC with fibrosis.