Upper Gastrointestinal Surgery Unit, Dr Sótero del Rio Hospital.
Department of Digestive Surgery, Division of Surgery, Faculty of Medicine, Pontifical Catholic University of Chile, Santiago, Chile.
Surg Laparosc Endosc Percutan Tech. 2020 Sep 11;31(2):165-169. doi: 10.1097/SLE.0000000000000857.
Gastric cancer is the second leading cause of death by cancer worldwide. Endoscopic submucosal dissection (ESD) is a technique that allows en bloc resection of early lesions of the digestive tract. It has curative potential in selected patients and benefits over gastrectomy for the treatment of early gastric cancer (EGC). The aim of this study is to present the results of ESD for EGC in a high-volume center in Chile.
Retrospective descriptive study of patients who underwent ESD for EGC at the Doctor Sótero del Río Hospital.
A total of 100 ESDs were performed in 96 patients between 2008 and 2020. Fifty-five percent were female patients, the average age was 68 years (range, 45 to 89 y). En bloc resection was achieved in 98% of cases and the rate of complications Clavien grade III or higher was 8.3%. There were no cases of perioperative mortality. Ninety-three percent of the dissections were classified as R0 and 83% met curative standards according to expanded criteria. The mean follow-up was 42 months (range, 1 to 144 mo). Overall survival was 97%. Cancer-specific survival was 100% and recurrence-free survival was 97%.
The present study describes the largest series of ESD for the treatment of EGC reported in Latin America. Our results support the feasibility of implementing ESD in Chile and indicate good oncological outcomes comparable to those reported in the large Asian series published to date.
胃癌是全球癌症死亡的第二大主要原因。内镜黏膜下剥离术（ESD）是一种能够整块切除消化道早期病变的技术。对于某些患者，它具有治疗效果，并且优于用于治疗早期胃癌（EGC）的胃切除术。本研究旨在介绍智利一家高容量中心进行 ESD 治疗 EGC 的结果。
对 2008 年至 2020 年期间在 Doctor Sótero del Río 医院接受 ESD 治疗 EGC 的患者进行回顾性描述性研究。
共对 96 例患者进行了 100 例 ESD，其中 55%为女性患者，平均年龄为 68 岁（范围 45 至 89 岁）。在 98%的病例中实现了整块切除，并发症 Clavien 分级 III 或更高的发生率为 8.3%。无围手术期死亡病例。93%的手术被分类为 R0，根据扩展标准，83%符合治愈标准。平均随访时间为 42 个月（范围 1 至 144 个月）。总生存率为 97%。癌症特异性生存率为 100%，无复发生存率为 97%。
本研究描述了拉丁美洲报告的最大系列 ESD 治疗 EGC。我们的结果支持在智利实施 ESD 的可行性，并表明与迄今为止发表的大型亚洲系列报道的结果相比，具有良好的肿瘤学结果。
