title: Endoscopic submucosal dissection for cancers of the remnant stomach after distal gastrectomy.
abstract: BACKGROUND
  Endoscopic submucosal dissection (ESD) of early gastric cancer is less invasive than surgical resection, and if technically feasible, it may result in less long-term morbidity than does incisional surgery. However, ESD is technically difficult in patients who have had a previous distal gastrectomy.
  
  
  OBJECTIVE
  Our purpose was to retrospectively assess the results of ESD of early gastric cancer in the remnant stomach.
  
  
  METHODS
  Case series.
  
  
  METHODS
  A total of 31 lesions in 30 patients with early remnant gastric cancer were treated with ESD at Okayama University Hospital, Tsuyama Central Hospital, Hiroshima City Hospital, Kagawa Prefectural Central Hospital, and Mitoyo General Hospital from March 2001 to January 2007.
  
  
  METHODS
  ESD.
  
  
  METHODS
  En bloc resection rate, complete resection rate, operation time, and complications.
  
  
  RESULTS
  En bloc resection and complete resection were achieved in 30 (97%) and in 23 (74%) lesions, respectively. The median operation time required for ESD in the remnant stomach was 113 minutes (range 45-450 minutes). Perforation occurred in 4 (13%). The incidence of delayed bleeding requiring blood transfusion was 0%.
  
  
  CONCLUSIONS
  Short duration of follow-up.
  
  
  CONCLUSIONS
  ESD is feasible in the remnant stomach but has a relatively high complication rate and should only be performed by experienced endoscopists.
authors.affiliation: Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: Ryuta
authors.initials: R
authors.lastname: Takenaka
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Kawahara
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Okada
authors.forename: Takao
authors.initials: T
authors.lastname: Tsuzuki
authors.forename: Satoru
authors.initials: S
authors.lastname: Yagi
authors.forename: Jun
authors.initials: J
authors.lastname: Kato
authors.forename: Nobuya
authors.initials: N
authors.lastname: Ohara
authors.forename: Tadashi
authors.initials: T
authors.lastname: Yoshino
authors.forename: Atsushi
authors.initials: A
authors.lastname: Imagawa
authors.forename: Shigeatsu
authors.initials: S
authors.lastname: Fujiki
authors.forename: Rie
authors.initials: R
authors.lastname: Takata
authors.forename: Masahiro
authors.initials: M
authors.lastname: Nakagawa
authors.forename: Motowo
authors.initials: M
authors.lastname: Mizuno
authors.forename: Tomoki
authors.initials: T
authors.lastname: Inaba
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Toyokawa
authors.forename: Kohsaku
authors.initials: K
authors.lastname: Sakaguchi
mesh_terms: D004210:Dissection / Q000379:methods*; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005743:Gastrectomy; D005753:Gastric Mucosa / Q000601:surgery; D018530:Gastric Stump; D006801:Humans; D013274:Stomach Neoplasms / Q000601:surgery*