title: Can we apply the same indication of endoscopic submucosal dissection for primary gastric cancer to remnant gastric cancer?
abstract: BACKGROUND
  Currently, remnant gastric cancer (RGC) is uncommon compared with gastric stump cancer, but early detection of gastric cancer and improved postsurgical survival will lead to increased incidence of RGC. Therefore, the indication of endoscopic submucosal dissection (ESD) for RGC is now required, but there have been no reports about this because of the lack of information for RGC.
  
  
  METHODS
  A retrospective review was conducted on 105 patients who underwent completion total gastrectomy (CTG) and 5 patients who underwent ESD for RGC between January 1998 and December 2010 at Yonsei University Hospital.
  
  
  RESULTS
  Forty-one (39 %) of 105 patients were diagnosed with early RGC. Among these patients, 6 had an absolute indication for ESD, whereas 11 met expanded criteria for ESD. In these patients, there was no association between the severity of the former gastric cancer and the current RGC. Also, none of these 17 patients had LN metastasis after CTG, and only 1 (2.4 %) of 41 early RGC patients had LN metastasis. Median operative time was 216 min for CTG and median hospital stay was 8 days. There were two major and five minor complications. One splenectomy was performed because of injury that occurred during CTG.
  
  
  CONCLUSIONS
  Applying the indication of ESD for primary gastric cancer to RGC would be possible, and it could be an alternative treatment option for selected patients with RGC.
authors.affiliation: Department of Surgery, Yonsei University Health System, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-ku, Seoul, 120-752, Republic of Korea.
authors.forename: Yoon Young
authors.initials: YY
authors.lastname: Choi
authors.forename: In Gyu
authors.initials: IG
authors.lastname: Kwon
authors.forename: Sang Kil
authors.initials: SK
authors.lastname: Lee
authors.forename: Hyun Ki
authors.initials: HK
authors.lastname: Kim
authors.forename: Ji Yeong
authors.initials: JY
authors.lastname: An
authors.forename: Hyoung Il
authors.initials: HI
authors.lastname: Kim
authors.forename: Jae Ho
authors.initials: JH
authors.lastname: Cheong
authors.forename: Richard Thomas
authors.initials: RT
authors.lastname: Mliwa
authors.forename: Sung Kwan
authors.initials: SK
authors.lastname: Shin
authors.forename: Yong Chan
authors.initials: YC
authors.lastname: Lee
authors.forename: Woo Jin
authors.initials: WJ
authors.lastname: Hyung
authors.forename: Sung Hoon
authors.initials: SH
authors.lastname: Noh
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D002288:Adenocarcinoma, Mucinous / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D002291:Carcinoma, Papillary / Q000473:pathology / Q000601:surgery; D018279:Carcinoma, Signet Ring Cell / Q000473:pathology / Q000601:surgery; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D005753:Gastric Mucosa / Q000473:pathology / Q000601:surgery*; D018530:Gastric Stump / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*