Clinical importance of colonoscopy in patients with gastric neoplasm undergoing endoscopic submucosal dissection

نویسندگان

  • Chieko Tsuchida
  • Naoto Yoshitake
  • Hitoshi Kino
  • Yoshihito Kaneko
  • Masakazu Nakano
  • Kohei Tsuchida
  • Keiichi Tominaga
  • Takako Sasai
  • Hironori Masuyama
  • Hidetsugu Yamagishi
  • Yasuo Imai
  • Hideyuki Hiraishi
چکیده

AIM To evaluate the usefulness of total colonoscopy (TCS) for patients undergoing gastric endoscopic submucosal dissection (ESD) and to assess risk factors for colorectal neoplasms. METHODS Of the 263 patients who underwent ESD at our department between May 2010 and December 2013, 172 patients undergoing TCS during a one-year period before and after ESD were targeted. After excluding patients with a history of surgery or endoscopic therapy for colorectal neoplasms, 158 patients were analyzed. Of the 868 asymptomatic patients who underwent TCS during the same period because of positive fecal immunochemical test (FIT) results, 158 patients with no history of either surgery or endoscopic therapy for colorectal neoplasms who were matched for age and sex served as the control group for comparison. RESULTS TCS revealed adenoma less than 10 mm in 53 patients (33.6%), advanced adenoma in 17 (10.8%), early colorectal cancer in 5 (3.2%), and advanced colorectal cancer in 4 (2.5%). When the presence or absence of adenoma less than 10 mm, advanced adenoma, and colorectal cancer and the number of adenomas were compared between patients undergoing ESD and FIT-positive patients, there were no statistically significant differences in any of the parameters assessed. The patients undergoing ESD appeared to have the same risk of colorectal neoplasms as the FIT-positive patients. Colorectal neoplasms were clearly more common in men than in women (P = 0.031). Advanced adenoma and cancer were significantly more frequent in patients with at least two of the following conditions: hypertension, dyslipidemia, and diabetes mellitus (P = 0.019). CONCLUSION In patients undergoing gastric ESD, TCS appears to be important for detecting synchronous double neoplasms. Advanced adenoma and cancer were more common in patients with at least two of the following conditions: hypertension, dyslipidemia, and diabetes mellitus. Caution is therefore especially warranted in patients with these risk factors.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Comparison of clinical outcomes after endoscopic submucosal dissection and surgery in the treatment of early gastric cancer

The feasibility of expanding the indications for endoscopic submucosal dissection to treat early gastric cancer based on long-term outcomes has shown conflicting results. This study aimed to investigate whether outcomes or adverse events associated with endoscopic submucosal dissection are comparable to those of surgery for early gastric cancer that including the absolute and expanded indicatio...

متن کامل

Future Development of Endoscopic Accessories for Endoscopic Submucosal Dissection

Endoscopic submucosal dissection (ESD) has recently been accepted as a standard treatment for patients with early gastric cancer (EGC), without lymph node metastases. Given the rise in the number of ESDs being performed, new endoscopic accessories are being developed and existing accessories modified to facilitate the execution of ESD and reduce complication rates. This paper examines the histo...

متن کامل

A phase II clinical trial of endoscopic submucosal dissection for early gastric cancer of undifferentiated type: Japan Clinical Oncology Group study JCOG1009/1010.

A Phase II clinical trial has been initiated to evaluate the efficacy and safety of endoscopic submucosal dissection for intramucosal (cT1a) gastric cancer of undifferentiated type. Patients with cT1a gastric cancer with undifferentiated-type adenocarcinoma are eligible for the study. The tumor size should be 2 cm or less without ulceration. The study will enroll a total of 325 patients from 51...

متن کامل

The Clinical Accuracy of Endoscopic Ultrasonography and White Light Imaging in Gastric Endoscopic Submucosal Dissection

PURPOSE Gastric mucosal neoplastic lesions should have characteristic endoscopic features for successful endoscopic submucosal dissection. MATERIALS AND METHODS Out of the 1,010 endoscopic submucosal dissection, we enrolled 62 patients that had the procedure cancelled. Retrospectively, whether the reasons for cancelling the endoscopic submucosal dissection were consistent with the indications...

متن کامل

Endoscopic Submucosal Dissection for Early Gastric Cancers with Uncommon Histology

Endoscopic submucosal dissection (ESD) enables en bloc curative resection of early gastric cancers (EGCs) with a negligible risk of lymph node metastasis (LNM). Although ESD for EGCs with absolute and expanded indications is safe, the results differ between EGCs with specialized and common histologies. EGC with papillary adenocarcinoma is a differentiated-type adenocarcinoma. At present, it is ...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:

دوره 23  شماره 

صفحات  -

تاریخ انتشار 2017