Division of Gastroenterology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Gastrointest Endosc. 2011 May;73(5):911-6. doi: 10.1016/j.gie.2010.11.046. Epub 2011 Feb 5.
Endoscopic submucosal dissection (ESD) is curative treatment for patients with early gastric cancer (EGC). Because of the technical difficulties, however, these procedures may take a long time, which can increase the rate of procedure-related complications.
To investigate the procedure time of ESD performed by 4 experts according to the location and size of the EGC.
Retrospectively analyzed study of prospectively collected data.
Tertiary care, academic medical center.
Complete ESDs were performed by 4 experts, primarily using an insulated-tip knife, for 916 EGCs.
ESD.
Procedure time relative to the location and size of tumors was analyzed along with other predictive factors.
ESD procedure time was increased as tumor size increased and for tumors in the middle and lower thirds of the stomach. Univariate analysis showed that tumor size, location, depth, submucosal fibrosis, and perforation during the procedure were significant predictors of procedure time. Multivariate analysis showed that proximal location, tumor size greater than 20 mm, submucosal fibrosis, and perforation during the procedure were independent predictors of a longer procedure time.
Single-center, retrospective study design.
Procedure time became longer as tumor location became higher and as tumor size increased, except for tumors in the upper third of the stomach. These findings suggest that tumor size and location may be useful in predicting the time required to perform ESD.
内镜黏膜下剥离术（ESD）是治疗早期胃癌（EGC）患者的一种有治愈可能的治疗方法。然而，由于技术上的困难，这些手术可能需要很长时间，这可能会增加与手术相关的并发症的发生率。
根据 EGC 的位置和大小，研究 4 位专家进行 ESD 的手术时间。
回顾性分析前瞻性收集的数据。
三级保健，学术医疗中心。
由 4 位专家主要使用电切刀完成的 916 例 EGC 的完全 ESD。
ESD。
分析肿瘤位置和大小与手术时间的关系以及其他预测因素。
随着肿瘤大小的增加和胃中、下部肿瘤的增加，ESD 手术时间增加。单因素分析显示，肿瘤大小、位置、深度、黏膜下纤维化和术中穿孔是手术时间的显著预测因素。多因素分析显示，近端位置、大于 20mm 的肿瘤大小、黏膜下纤维化和术中穿孔是手术时间延长的独立预测因素。
单中心、回顾性研究设计。
除了胃上部的肿瘤外，随着肿瘤位置的升高和肿瘤大小的增加，手术时间会延长。这些发现表明，肿瘤大小和位置可能有助于预测进行 ESD 所需的时间。
