title: Laparoscopic gastrectomy after incomplete endoscopic resection for early             gastric cancer.
abstract: Endoscopic submucosal dissection (ESD) utilizes electrical coagulation,             which can cause burns, fibrosis and adhesion of the stomach and surrounding tissue;             these complications might increase the surgical difficulties for subsequent laparoscopy-assisted             gastrectomy (LAG) and the risk of complications. However, scarce data are available             on the influence of previous ESD on LAG. The purpose of this study was to evaluate             the feasibility and safety of LAG following incomplete ESD in patients with early             gastric cancer. Ninety-seven patients who underwent LAG were analyzed retrospectively;             17 patients had undergone ESD previously and the remaining 80 patients had no             history of ESD. Clinicopathological data and surgical outcomes were compared between             the two groups. No differences were observed in surgical outcomes of LAG after             ESD in terms of operation time, intraoperative blood loss, total number of harvested             lymph nodes, time until start of flatus, and postoperative hospital stay. These             results were not influenced by tumor location and operative procedures. In conclusion,             in terms of surgical outcomes, LAG is a safe and feasible procedure for the treatment             of early gastric cancer regardless of previous endoscopic treatment. LAG may be             the first-choice radical treatment after incomplete ESD for early gastric cancer.
authors.affiliation: Department of Surgery, National Defense Medical College, Tokorozawa 359-8513, Japan. tsujihi@ndmc.ac.jp
authors.forename: Hironori
authors.initials: H
authors.lastname: Tsujimoto
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Yaguchi
authors.forename: Isao
authors.initials: I
authors.lastname: Kumano
authors.forename: Risa
authors.initials: R
authors.lastname: Takahata
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Matsumoto
authors.forename: Kazumichi
authors.initials: K
authors.lastname: Yoshida
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Horiguchi
authors.forename: Suefumi
authors.initials: S
authors.lastname: Aosasa
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ono
authors.forename: Junji
authors.initials: J
authors.lastname: Yamamoto
authors.forename: Kazuo
authors.initials: K
authors.lastname: Hase
mesh_terms: D000368:Aged; D005240:Feasibility Studies; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects; D005753:Gastric Mucosa / Q000473:pathology / Q000601:surgery; D005773:Gastroscopy; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery; D008297:Male; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000601:surgery*; D016896:Treatment Outcome