Characteristics of Gastric Stasis due to Deformation after Endoscopic Submucosal Dissection in the Lower Part of the Stomach

Takayama H.a· Toyonaga T.b,c· Yoshizaki T.a· Abe H.a· Nakai T.a· Ueda C.a· Urakami S.a· Kaku H.a· Shimamoto Y.a· Matsumoto K.a· Tsuda K.a· Sakaguchi H.a· Baba S.c· Takihara H.c· Ikezawa N.a· Tanaka S.a· Takao M.a· Takao T.b· Morita Y.a· Kodama Y.a

Author affiliations

aDivision of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
bDepartment of Endoscopy, Kobe University Hospital, Kobe, Japan
cDepartment of Endoscopy, Kishiwada Tokushukai Hospital, Kishiwada, Japan

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Article / Publication Details

First-Page Preview

Abstract of Research Article

Received: March 21, 2022
Accepted: January 13, 2023
Published online: March 22, 2023

Number of Print Pages: 8
Number of Figures: 3
Number of Tables: 4

ISSN: 0012-2823 (Print)
eISSN: 1421-9867 (Online)

For additional information: https://www.karger.com/DIG

Abstract

Introduction: Gastric stasis due to deformation occurs after endoscopic submucosal dissection in the lower part of the stomach. Endoscopic balloon dilation can improve gastric stasis due to stenosis; however, endoscopic balloon dilation cannot improve gastric stasis due to deformation. Furthermore, the characteristics of gastric stasis due to deformation are unknown. This study aimed to evaluate the characteristics of gastric stasis due to deformation after endoscopic submucosal dissection in the lower part of the stomach, focusing on the differences between stenosis and deformation. Methods: We retrospectively reviewed 41 patients with gastric stasis after endoscopic submucosal dissection in the lower part of the stomach. We evaluated the characteristics of cases with gastric stasis due to deformation, such as the risk factors of deformation and the rate of deformation in each group with risk factors. Results: Deformation was observed in 12% (5/41) of the patients with gastric stasis. All cases of deformation had a circumferential extent of the mucosal defect greater than 3/4. The number of cases with pyloric dissection was significantly lower in the deformation group than in the non-deformation group (0% vs. 72%; p = 0.004). The deformation group also had a significantly higher number of cases with angular dissection than the non-deformation group (100% vs. 17%; p < 0.001). Moreover, the deformation cases had a significantly larger specimen diameter (p < 0.001). Deformation was observed only in cases with angular and non-pyloric dissections. Deformation was not observed in cases with angular and pyloric dissections. Conclusions: All cases of gastric stasis due to deformation had a circumferential extent of the mucosal defect greater than 3/4. Deformation was also likely to occur in cases with a larger dissection that exceeded the angular region without pyloric dissection.

© 2023 S. Karger AG, Basel

References Gotoda T, Yamamoto H, Soetikno RM. Endoscopic submucosal dissection of early gastric cancer. J Gastroenterol. 2006;41(10):929–42. Oda I, Gotoda T, Hamanaka H, Eguchi T, Saito Y, Matsuda T, et al. Endoscopic submucosal dissection for early gastric cancer: technical feasibility, operation time and com- plications from a large consecutive series. Dig Endosc. 2005;17(1):54–8. Yamamoto H, Kawata H, Sunada K, Sasaki A, Nakazawa K, Miyata T, et al. Successful en-bloc resection of large superficial tumors in the stomach and colon using sodium hyaluronate and small-caliber-tip transparent hood. Endoscopy. 2003;35(8):690–4. Oyama T, Kikuchi Y. Aggressive endoscopic mucosal resection in the upper GI tract: hook knife EMR method. Minim Invasive Ther Allied Technol. 2002;11(5–6):291–5. Yahagi N, Fujishiro M, Kakushima N, Kobayashi K, Hashimoto T, Oka M, et al. Endoscopic submucosal dis- section for early gastric cancer using the tip ofan electrosurgical snare (thin type). Dig Endosc. 2004;16(1):34–8. Oda I, Saito D, Tada M, Iishi H, Tanabe S, Oyama T, et al. A multicenter retrospective study of endoscopic resection for early gastric cancer. Gastric Cancer. 2006;9(4):262–70. Takizawa K, Oda I, Gotoda T, Yokoi C, Matsuda T, Saito Y, et al. Routine coagulation of visible vessels may prevent delayed bleeding after endoscopic submucosal dissection: an analysis of risk factors. Endoscopy. 2008;40(3):179–83. Miyahara K, Iwakiri R, Shimoda R, Sakata Y, Fujise T, Shiraishi R, et al. Perforation and postoperative bleeding of endoscopic submucosal dissection in gastric tumors: analysis of 1190 lesions in low- and high-volume centers in Saga, Japan. Digestion. 2012;86(3):273–80. Gong EJ, Kim DH, Jung HY, Choi YK, Lim H, Choi KS, et al. Clinical outcomes of endoscopic resection for gastric neoplasms in the pylorus. Surg Endosc. 2015;29(12):3491–8. Kakushima N, Tanaka M, Sawai H, Imai K, Kawata N, Hagiwara T, et al. Gastric obstruction after endoscopic submucosal dissection. United Eur Gastroenterol J. 2013;1(3):184–90. Iizuka H, Kakizaki S, Sohara N, Onozato Y, Ishihara H, Okamura S, et al. Stricture after endoscopic submucosal dissection for early gastric cancers and adenomas. Dig Endosc. 2010;22(4):282–8. Sumiyoshi T, Kondo H, Minagawa T, Fujii R, Sakata K, Inaba K, et al. Risk factors and management for gastric stenosis after endoscopic submucosal dissection for gastric epithelial neoplasm. Gastric Cancer. 2017;20(4):690–8. Coda S, Oda I, Gotoda T, Yokoi C, Kikuchi T, Ono H. Risk factors for cardiac and pyloric stenosis after endoscopic submucosal dissection, and efficacy of endoscopic balloon dilation treatment. Endoscopy. 2009;41(5):421–6. Lee JU, Park MS, Yun SH, Yang MA, Han SH, Lee YJ, et al. Risk factors and management for pyloric stenosis occurred after endoscopic submucosal dissection adjacent to pylorus. Medicine. 2016;95(50):e5633. Takayama H, Toyonaga T, Yoshizaki T, Abe H, Nakai T, Ueda C, et al. Timing of pyloric stenosis and effectiveness of endoscopic balloon dilation after pyloric endoscopic submucosal dissection. J Gastroenterol Hepatol. 2021;36(11):3158–63. Yoshizaki T, Obata D, Aoki Y, Okamoto N, Hashimura H, Kano C, et al. Endoscopic submucosal dissection for early gastric cancer on the lesser curvature in upper third of the stomach is a risk factor for postoperative delayed gastric emptying. Surg Endosc. 2018;32(8):3622–9. Ohara Y, Toyonaga T, Tanabe A, Takihara H, Baba S, Inoue T, et al. Endoscopic antralplasty for severe gastric stasis after wide endoscopic submucosal dissection in the antrum. Clin J Gastroenterol. 2016;9(2):63–7. Uozumi T, Sakano H, Yoshida M, Tokuchi K, Sumiyoshi T, Tomita Y, et al. Laparoscopic gastrojejunostomy to manage gastric outlet obstruction associated with endoscopic submucosal dissection of large gastric epithelial neoplasms : a two-case report. DEN Open. 2022;2(1):e18. Toyonaga T, Man-i M, East JE, Nishino E, Ono W, Hirooka T, et al. 1,635 Endoscopic submucosal dissection cases in the esophagus, stomach, and colorectum: complication rates and long-term outcomes. Surg Endosc. 2013;27(3):1000–8. Toyonaga T, Inokuchi H, Man-I M, Morita Y, Yoshida M, Kutsumi H, et al. Endoscopic submucosal dissection using water jet short needle knives (Flush knife) for the treatment of gastrointestinal epithelial neoplasms. Acta Endoscopica. 2007;37(5):645–55. Toyonaga T, Nishino E, Hirooka T, Dozaiku T, Sugiyama T, Iwata Y, et al. Use of short needle knife for esophageal endoscopic submucosal dissection. Dig Endosc. 2005;17(3):246–52. Toyonaga T, Nishino E, Hirooka T, Ueda C, Noda K. Intraoperative bleeding in endoscopic submucosal dissection in the stomach and strategy for prevention and treatment. Dig Endosc. 2006;18(s1):S123–7. Toyonaga T, Man-i M, Fujita T, East JE, Nishino E, Ono W, et al. Retrospective study of technical aspects and complications of endoscopic submucosal dissection for laterally spreading tumors of the colorectum. Endoscopy. 2010;42(9):714–22. Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2010 (ver 3). Gastric Cancer. 2011;14(2):113–23. Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2014 (ver 4). Gastric Cancer. 2017;20(1):1–19. Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2018 (5th edition). Gastric Cancer. 2021;24(1):1–21. Kishida Y, Kakushima N, Kawata N, Tanaka M, Takizawa K, Imai K, et al. Adverse events associated with endoscopic dilation for gastric stenosis after endoscopic submucosal dissection for early gastric cancer. Surg Endosc. 2015;29(12):3776–82. Tsunada S, Ogata S, Mannen K, Arima S, Sakata Y, Shiraishi R, et al. Case series of endoscopic balloon dilation to treat a stricture caused by circumferential resection of the gastric antrum by endoscopic submucosal dissection. Gastrointest Endosc. 2008;67(6):979–83. Article / Publication Details

First-Page Preview

Abstract of Research Article

Received: March 21, 2022
Accepted: January 13, 2023
Published online: March 22, 2023

Number of Print Pages: 8
Number of Figures: 3
Number of Tables: 4

ISSN: 0012-2823 (Print)
eISSN: 1421-9867 (Online)

For additional information: https://www.karger.com/DIG

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