title: Gastric mucosal cancer smaller than 7mm can be treated with conventional endoscopic mucosal resection as effectively as with endoscopic submucosal dissection.
abstract: OBJECTIVE
  Recently, endoscopic submucosal dissection (ESD) has been accepted for the treatment of gastrointestinal mucosal neoplasms because of the higher en bloc resection rate. However, ESD is technically more difficult, requires a longer procedure time and has more frequent complications compared with conventional endoscopic mucosal resection (EMR). We evaluated retrospectively the clinical outcomes of ESD compared with EMR to determine the size of the lesion for choosing EMR rather than ESD.
  
  
  METHODS
  Three hundred and sixty-five lesions of early gastric cancer were treated endoscopically (146 by EMR and 219 by ESD). We compared en bloc resection, residual tumor and recurrence-free rates between EMR and ESD.
  
  
  RESULTS
  En bloc resection rate was significantly higher with ESD (88.5%) than EMR (45.2%). With regard to lesions < or = 7mm in size, en bloc resection, residual tumor and recurrence-free rates did not differ.
  
  
  CONCLUSIONS
  Gastric mucosal cancer < or = 7mm can be treated with EMR as effectively as with ESD.
authors.affiliation: Department of Gastroenterology and Metabolism, University of Occupational and Environmental Health, Japan, School of Medicine, Kitakyushu, Japan. dxjrb778@ybb.ne.jp
authors.forename: Tatsuyuki
authors.initials: T
authors.lastname: Watanabe
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Kume
authors.forename: Mayumi
authors.initials: M
authors.lastname: Taip
authors.forename: Michihiko
authors.initials: M
authors.lastname: Shibata
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kubo
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Ejiri
authors.forename: Makoto
authors.initials: M
authors.lastname: Otsuki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*