title: Clinical outcomes of EMR for gastric tumors: historical pilot evaluation between endoscopic submucosal dissection and conventional mucosal resection.
abstract: BACKGROUND
  EMR is currently a standard treatment for mucosal gastric tumors. Endoscopic submucosal dissection (ESD) has been developed for en bloc resection.
  
  
  OBJECTIVE
  We evaluated the clinical outcomes of ESD compared with conventional EMR.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  A historical control study was performed between EMR and ESD.
  
  
  METHODS
  EMR of 245 gastric tumors was performed in 229 patients. Lesions were divided into two groups. Conventional EMR was performed in group A from February 1999 to June 2001, and ESD was performed in group B from July 2001 to March 2004. Group B was divided into subgroups: subgroup B-1 underwent ESD from July 2001 to March 2003 and subgroup B-2 from April 2003 to March 2004.
  
  
  METHODS
  All lesions were resected with conventional EMR or with ESD.
  
  
  METHODS
  En bloc resection rate, rate in completeness of resection, required time, remnant ratio, and complications were evaluated.
  
  
  RESULTS
  With regard to lesions >10 mm in size, the en bloc resection rate and the rate in completeness of resection of group B was significantly higher than that of group A (p < 0.01). Although the required time was longer in group B than A (p < 0.01), it was shorter in subgroup B-2 compared with B-1 (p < 0.05) with lesions < or =10 mm in size. The remnant ratio and perforation rate were not different between groups.
  
  
  CONCLUSIONS
  Not applicable.
  
  
  CONCLUSIONS
  The en bloc resection rate was better with ESD than with conventional EMR. The required time was longer in ESD, but this disadvantage might be improved with experience.
authors.affiliation: Department of Internal Medicine, Radiology, Pathology, Saga Prefectural Hospital Koseikan, Saga Japan.
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Watanabe
authors.forename: Shinichi
authors.initials: S
authors.lastname: Ogata
authors.forename: Seiji
authors.initials: S
authors.lastname: Kawazoe
authors.forename: Kazuyo
authors.initials: K
authors.lastname: Watanabe
authors.forename: Takanori
authors.initials: T
authors.lastname: Koyama
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Kajiwara
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Shimoda
authors.forename: Yukari
authors.initials: Y
authors.lastname: Takase
authors.forename: Kouji
authors.initials: K
authors.lastname: Irie
authors.forename: Masanobu
authors.initials: M
authors.lastname: Mizuguchi
authors.forename: Seiji
authors.initials: S
authors.lastname: Tsunada
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Iwakiri
authors.forename: Kazuma
authors.initials: K
authors.lastname: Fujimoto
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery; D000236:Adenoma / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D013505:Digestive System Surgical Procedures; D004210:Dissection / Q000379:methods; D005260:Female; D005753:Gastric Mucosa / Q000601:surgery*; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*