title: Clinical advantages of endoscopic submucosal dissection for gastric cancers in remnant stomach surpass conventional endoscopic mucosal resection.
abstract: OBJECTIVE
  Endoscopic submucosal dissection was developed to address the shortcomings of conventional endoscopic mucosal resection. The present study evaluated the benefits of endoscopic submucosal dissection compared with conventional endoscopic mucosal resection for the treatment of neoplasms arising from the remnant stomach after gastrectomy or esophagectomy.
  
  
  METHODS
  This study, which was designed as a historical control study, evaluated 22 gastric cancers in remnant cancers treated by conventional endoscopic mucosal resection and another 40 cancers treated by endoscopic submucosal dissection.
  
  
  RESULTS
  Patient characteristic between the two groups were not different except for tumor size, which was larger in patients with endoscopic submucosal dissection. The local complete resection rate and the curative resection rate were significantly higher in the endoscopic submucosal dissection group compared to those in the mucosal resection group (95.0% vs 40.9% and 80.0% vs 40.9%, respectively). Complication rate showed no significant difference in the two groups, although submucosal dissection required a longer operation time.
  
  
  CONCLUSIONS
  Endoscopic submucosal dissection represents a reliable treatment for gastric cancers in the remnant stomach, surpassing endoscopic mucosal resection.
authors.affiliation: Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan. torashu@hotmail.com
authors.forename: Shu
authors.initials: S
authors.lastname: Hoteya
authors.forename: Toshiro
authors.initials: T
authors.lastname: Iizuka
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kikuchi
authors.forename: Naohisa
authors.initials: N
authors.lastname: Yahagi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005743:Gastrectomy; D005753:Gastric Mucosa / Q000601:surgery*; D018530:Gastric Stump / Q000601:surgery*; D005773:Gastroscopy / Q000009:adverse effects / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*