Palacios-Salas Fernando, Benites-Goñi Harold, Marin-Calderón Luis, Bardalez-Cruz Paulo, Vásquez-Quiroga Jorge, Alva-Alva Edgar, Medina-Morales Bryan, Asencios-Cusihuallpa Jairo
Clínica Delgado y Oncosalud - AUNA, Lima, Perú.
Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Perú.
Clin Endosc. 2022 Mar;55(2):248-255. doi: 10.5946/ce.2021.192. Epub 2021 Nov 12.
BACKGROUND/AIMS: Endoscopic submucosal dissection (ESD) is the preferred technique for treating early gastric cancer (EGC). However, very few studies have been conducted in South America. This study aimed to assess the efficacy and safety of ESD for EGC.
We analyzed data from a prospective cohort from 2013 to 2020. A total of 152 superficial gastric neoplasms that fulfilled the absolute or expanded criteria for ESD were included. Outcomes were en bloc, R0, and curative resection rates, incidence of adverse events, and length of procedure.
The age of the enrolled patients was 68.4±11.3 years. The number of included patients based on the absolute and expanded indications was 150 and 2, respectively. En bloc, R0, and curative resections were achieved in 98.0%, 96.1%, and 89.5% of the cases, respectively. Bleeding and perforation were reported in 5.9% and 6.6% of the cases, respectively. Histopathological examination revealed lowgrade dysplasia, high-grade dysplasia, well-differentiated adenocarcinoma, and poorly differentiated adenocarcinoma in 13, 20, 117, and 2 cases, respectively.
Our study shows that ESD performed by properly trained endoscopists in reference centers is safe and effective, with comparable therapeutic outcomes to those reported in the Eastern series.
背景/目的:内镜黏膜下剥离术(ESD)是治疗早期胃癌(EGC)的首选技术。然而,在南美洲进行的相关研究非常少。本研究旨在评估ESD治疗EGC的疗效和安全性。
我们分析了2013年至2020年前瞻性队列的数据。共纳入152例符合ESD绝对或扩展标准的浅表性胃肿瘤。观察指标包括整块切除率、R0切除率、根治性切除率、不良事件发生率及手术时间。
入组患者年龄为68.4±11.3岁。基于绝对指征和扩展指征纳入的患者分别为150例和2例。整块切除、R0切除和根治性切除分别在98.0%、96.1%和89.5%的病例中实现。出血和穿孔分别在5.9%和6.6%的病例中报告。组织病理学检查显示低级别异型增生、高级别异型增生、高分化腺癌和低分化腺癌分别有13例、20例、117例和2例。
我们的研究表明,在参考中心由经过适当培训的内镜医师进行ESD是安全有效的,治疗结果与东方系列报道相当。