additional gastrectomy after endoscopic submucosal dissection for early gastric cancer patients with comorbidities额外的胃切除术后早期胃癌内镜黏膜下剥离并发症患者.pdfVIP

Hindawi Publishing Corporation International Journal of Surgical Oncology Volume 2012, Article ID 379210, 7 pages doi:10.1155/2012/379210 Clinical Study Additional Gastrectomy after Endoscopic Submucosal Dissection for Early Gastric Cancer Patients with Comorbidities Naohiko Koide, Daisuke Takeuchi, Akira Suzuki, Satoshi Ishizone, and Shinichi Miyagawa Department of Surgery, Shinshu University School of Medicine, Matsumoto 390-8621, Japan Correspondence should be addressed to Naohiko Koide, nkoide@shinshu-u.ac.jp Received 20 December 2011; Revised 11 February 2012; Accepted 20 February 2012 Academic Editor: Marco Bernini Copyright © 2012 Naohiko Koide et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Purpose. We investigated the clinicopathologic features of early gastric cancer (EGC) patients who have undergone additional gastrectomy after endoscopic submucosal dissection (ESD) because of their comorbidities. Methods. Eighteen (7.1%) of 252 GC patients were gastrectomized after prior ESD. Reasons for further surgery, preoperative and postoperative problems, and the clinical outcome were determined. Results. The 18 patients had submucosal EGC and several co-morbidities. Other primary cancers were observed in 8 (44.4%). Histories of major abdominal operations were observed in 6 (33.3%). Fourteen patients (77.8%) hoped for endoscopic treatment. Due to additional gastrectomy, residual cancer was suspected in 10, and node metastasis was suspected in 11. A cancer remnant was histologically observed in one. Node metastasis was detected in 3 (16.7%). Small EGC was newly detected in 4. Consequ