title: Magnifying endoscopy for diagnosis of residual/local recurrent gastric neoplasms after previous endoscopic treatment.
abstract: BACKGROUND
  Incomplete resection of gastric neoplasms by endoscopic treatment could lead to residual/local recurrence, which may be difficult to identify. This study aimed to evaluate the usefulness of magnifying endoscopy for identifying and demarcating residual/local recurrent gastric neoplasms after endoscopic treatment.
  
  
  METHODS
  Between December 2004 and November 2010, magnifying endoscopy was performed in 15 patients with residual/local recurrent gastric neoplasms. All patients underwent conventional magnifying endoscopy (CME) and enhanced-magnification endoscopy with acetic acid instillation (EME) after conventional endoscopy (CE). Eleven patients additionally underwent magnifying endoscopy using narrow-band imaging (NBI-ME) and a combination of narrow-band imaging and acetic acid instillation (NBI-EME). For each procedure, it was recorded whether the location and circumferential demarcation of the lesions were identified. All lesions were resected by endoscopic submucosal dissection.
  
  
  RESULTS
  Eleven lesions were identified using CE. However, two and four additional lesions were identified using CME and EME, respectively. In 11 cases, NBI-ME and NBI-EME were performed and all lesions were identified. Three lesions, which were identified by CME, were not demarcated circumferentially. All 15 lesions were well demarcated by EME and 11 by NBI-ME and NBI-EME. Of the resected specimens, histopathology indicated that ten lesions were differentiated tubular adenocarcinomas and five lesions were adenomas. The histopathological diagnosis of the location and demarcation of all neoplasms corresponded to endoscopic findings.
  
  
  CONCLUSIONS
  Magnifying endoscopy techniques (CME, EME, NBI-ME, and NBI-EME) may be useful for identifying and demarcating residual/local recurrent gastric neoplasms after previous endoscopic treatment.
authors.affiliation: Department of Endoscopic Medicine, Mie University Hospital, Tsu, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Kosaka
authors.forename: Kyosuke
authors.initials: K
authors.lastname: Tanaka
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Tano
authors.forename: Reiko
authors.initials: R
authors.lastname: Takayama
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Nishikawa
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Hamada
authors.forename: Hideki
authors.initials: H
authors.lastname: Toyoda
authors.forename: Katsuhito
authors.initials: K
authors.lastname: Ninomiya
authors.forename: Masaki
authors.initials: M
authors.lastname: Katsurahara
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Inoue
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Horiki
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Katayama
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Takei
mesh_terms: D019342:Acetic Acid; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007202:Indicators and Reagents; D008297:Male; D008488:Medical Illustration; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D018365:Neoplasm, Residual; D019233:Retreatment; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000601:surgery
chemical_list: D007202:Indicators and Reagents; D019342:Acetic Acid