Outcomes of the Conventional versus Pocket-Creation Method for Endoscopic Submucosal Dissection of Gastric Body Tumors Using a Dual Knife: A Retrospective Study

Gut Liver. 2023 Jul 15;17(4):547-557. doi: 10.5009/gnl220226. Epub 2022 Oct 21.

Abstract

Background/aims: Various endoscopic submucosal dissection (ESD) methods for gastric tumors have been tried. However, no studies have yet compared results according to the ESD method for gastric body tumors using a dual knife. The objective of this study was to compare outcomes of two ESD methods for gastric body tumors: the pocket-creation method and conventional method.

Methods: Patients who underwent ESD for a gastric body tumor were retrospectively reviewed. Patients were divided into two groups according to the ESD method: the conventional method (group I) and pocket-creation method (group II). Characteristics of patients and tumors, hospitalization period, incidence of complications, resection margin status, incidence of surgical operation, procedure time, and laboratory findings were investigated.

Results: Of the total of 100 patients, 52 belonged to group I and 48 to group II. All tumors were successfully resected en bloc. Resection margin involvement was found in six (11.5%) of group I and six (12.5%) of group II. Complications were observed in seven (13.5%; major complication five, minor two) of group I and eight (16.7%; major two, minor six) of group II. There were no significant differences in ESD outcomes such as hospitalization period, incidence of complications, resection margin status, incidence of surgical operation, procedure time, or inflammatory response after ESD between the two groups.

Conclusions: Both methods are suitable for treating gastric body tumors with adequate treatment success rates and comparable complication rates.

Keywords: Endoscopic submucosal dissection; Endoscopy; Pocket-creation method; Stomach neoplasms.

MeSH terms

  • Endoscopic Mucosal Resection* / adverse effects
  • Gastric Mucosa / pathology
  • Gastric Mucosa / surgery
  • Gastroscopy / methods
  • Humans
  • Margins of Excision
  • Retrospective Studies
  • Stomach Neoplasms* / pathology
  • Stomach Neoplasms* / surgery
  • Treatment Outcome

Grants and funding

ACKNOWLEDGEMENTS This research was supported by Korean Gastrointestinal Endoscopy Research Foundation, 2022 (Project Number: 6H220301001S000100).