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Korean J Helicobacter  Up Gastrointest Res > Volume 14(3); 2014 > Article
The Korean Journal of Helicobacter  and Upper Gastrointestinal Research 2014;14(3):174-180.
DOI: https://doi.org/10.7704/kjhugr.2014.14.3.174    Published online September 10, 2014.
Feasibility of Planned Endoscopic Submucosal Dissection with Snaring for Gastric Adenoma Compared with Standard Endoscopic Submucosal Dissection
Gook Hwan Jang, Hyung Hun Kim, Seong Yeon Ahn
1Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea. drhhkim@gmail.com
2Department of Internal Medicine, School of Medicine, The Catholic University of Korea, Seoul, Korea.
3College of Nursing, The Catholic University of Korea, Seoul, Korea.
Planned endoscopic submucosal dissection with snaring (ESD-S) is thought to shorten operating time spent on submucosal dissection, but may lead to uncertainty of en bloc resection or to a possible increase in tumor-positive margins. The purpose of the present study is to investigate the feasibility of ESD-S as a planned procedure for gastric adenoma. MATERIALS AND METHODS: The medical records of 99 patients who underwent ESD-S or ESD for gastric adenoma between May 2011 and May 2012 were retrospectively reviewed. We analyzed the differences between the ESD-S and the ESD groups, focusing on rates of en bloc resection and pathologic complete resection, mean operation time, and complications. RESULTS: The mean operation time was significantly lower in the ESD-S group than in the ESD group (19.9+/-11.2 vs. 33.8+/-19.9, P=0.012). Cases with an operation time under 30 minutes were more frequent in the ESD-S group (88.9% vs. 48.1%, OR=8.615, 95% CI=2.949~25.168). There were no significant differences in en bloc resection, histologic complete resection, or complication rates between the two groups. CONCLUSIONS: ESD-S has a time advantage over ESD with a comparable compete resection rate. ESD-S can be considered a planned method for available early gastric adenoma.
Key Words: Endoscopy; Treatment; Time

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