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, 4 (2), 186-91

Efficacy and Safety of Endoscopic Submucosal Dissection for Early Gastric Cancer in Patients With Comorbid Diseases

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Efficacy and Safety of Endoscopic Submucosal Dissection for Early Gastric Cancer in Patients With Comorbid Diseases

Beom Jin Kim et al. Gut Liver.

Abstract

Background/aims: Endoscopic submucosal dissection (ESD), a new and potentially curative method for treating gastrointestinal neoplasms, may have longer procedure time and the risk of complications when compared to conventional endoscopic mucosal resection. This study evaluated the efficacy and safety of ESD in patients with comorbid diseases.

Methods: The outcomes of 337 patients who underwent ESD for early gastric cancer at Samsung Medical Center from April 2003 to December 2006 were analyzed retrospectively. The Charlson comorbidity scale was used to divide the patients into low-risk (no risk factor) and high-risk (at least one risk factor) groups. The outcomes and complications were compared between the high- and low-risk groups.

Results: The low- and high-risk groups comprised 240 and 97 patients with mean ages of 61.1 and 64.7 years, respectively (p=0.002). Tumor location, tumor size, depth of invasion, procedure duration, and rates of en bloc resection, complete resection, complication, and recurrence did not differ significantly between the two groups (p>0.05).

Conclusions: ESD may be a safe and effective treatment for early gastric cancer in patients with comorbid diseases.

Keywords: Comorbid disease; Complication; Early gastric cancer; Endoscopic submucosal dissection.

Figures

Fig. 1
Fig. 1
Comorbid diseases in the high-risk group. Among patients in the high-risk group, the prevalence rates are higher for diabetes mellitus and cardiovascular disease than for hepatic, pulmonary, renal, and hematologic disesases.
Fig. 2
Fig. 2
Complication rates in patients with various comorbid diseases. The rates of bleeding and perforation are 5% and 7%, respectively, in the low-risk group, and they are highest in patients with cardiovascular disease or renal disease in the high-risk group. However, the rates does not differ significantly between the two groups.

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