Clinical outcomes of double endoscopic intralumenal surgery for early gastric cancer.
BACKGROUND
Endoscopic submucosal dissection (ESD) is a safe, efficacious, and minimally invasive technique for superficial gastrointestinal neoplasms. However, the procedure is long, complex, and associated with higher complication rates. To overcome such limitations, the authors devised a double endoscopic intralumenal operation (DEILO) and assessed its efficacy and safety for superficial gastric neoplasms.


METHODS
The DEILO procedure was performed for 31 gastric cancers. This novel technique is characterized by the use of two endoscopes, one for lifting lesions and the other for cutting them, inserted into the stomach simultaneously.


RESULTS
The DEILO technique was performed successfully, and en bloc resection was achieved for 29 (93.5%) of 31 patients. Histologically, curative resection was achieved for 26 lesions (83.8%). The mean operating time for DEILO was 34 min (range, 20-107 min). Two patients experienced postoperative hemorrhage, which was controlled endoscopically. Perforation occurred in two cases (6.4%), both of which were successfully treated nonsurgically.


CONCLUSIONS
The DEILO procedure appears to shorten the operating time for ESD, with comparable efficacy and complication rates.
Mochiki
Erito
E
Department of General Surgical Science, Faculty of Medicine, Gunma University, 3-39-15 Showa-machi, Maebashi 371-8511, Japan. emochiki@showa.gunma-u.ac.jp
Yanai
Mitsuhiro
M
Toyomasu
Yoshitaka
Y
Ogata
Kyouichi
K
Andoh
Hiroyuki
H
Ohno
Tetsuro
T
Aihara
Ryusuke
R
Asao
Takayuki
T
Kuwano
Hiroyuki
H
D000230:Adenocarcinoma / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D018279:Carcinoma, Signet Ring Cell / Q000601:surgery*; D005260:Female; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D013274:Stomach Neoplasms / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
Ann Surg. 2004 Jan;239(1):22-7
14685096
Gastrointest Endosc. 2008 Jan;67(1):128-32
18054010
J Gastroenterol. 2006 Oct;41(10):929-42
17096062
Gastrointest Endosc. 2006 Dec;64(6):877-83
17140890
Gut. 2001 Feb;48(2):225-9
11156645
Gastrointest Endosc. 2008 Jul;68(1):11-8
18577472
Gastrointest Endosc. 2005 Aug;62(2):297-301
16046999
J Gastroenterol Hepatol. 2007 Jun;22(6):821-6
17565635
Gastric Cancer. 2008;11(1):47-52
18373177
J Gastroenterol Hepatol. 2009 Mar;24(3):379-83
19054263
Gastrointest Endosc. 2004 Feb;59(2):284-8
14745409
Jpn J Clin Oncol. 2004 Mar;34(3):118-23
15078906
Gastric Cancer. 2007;10(1):1-11
17334711
Endoscopy. 2006 Oct;38(10):1007-10
16673308
Gastric Cancer. 2000 Dec;3(4):219-225
11984739
Gastric Cancer. 1998 Dec;1(1):10-24
11957040
Clin Gastroenterol Hepatol. 2005 Jul;3(7 Suppl 1):S71-3
16013003