title: Outcomes of patients with early gastric cancer who underwent double endoscopic intraluminal surgery.
abstract: OBJECTIVE
  Endoscopic submucosal dissection (ESD) has been used to treat patients with nonulcerated early gastric cancers of 2  cm or less, because the incidence of lymph node metastasis is negligible. However, the standard ESD procedure is long, complex, and associated with high complication rates. To overcome these limitations, we devised a double endoscopic intraluminal operation (DEILO) and assessed its efficacy and safety for superficial gastric neoplasms in a preliminary prospective study.
  
  
  METHODS
  The DEILO procedure was performed on 101 patients with gastric cancers. Two endoscopes were simultaneously inserted into the stomach. One endoscope was used to lift the lesion, and the other was used to excise the lesion.
  
  
  RESULTS
  The DEILO technique was performed successfully, and en bloc resection was achieved for 98 (97.0%) of 101 patients. Histologically curative resection was achieved for 85 lesions (84.2%). The mean operating time was 70 min (range 20-178 min). Perforation occurred in four patients (4.0%), all of whom were successfully treated nonsurgically. Three patients developed postoperative hemorrhage, which was controlled endoscopically.
  
  
  CONCLUSIONS
  The DEILO procedure appears to shorten the operating time for ESD, with efficacy and complication rates comparable with the standard procedure.
authors.affiliation: Department of General Surgical Science (Surgery I), Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan. m07702047@gunma-u.ac.jp.
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Toyomasu
authors.affiliation: Department of General Surgical Science (Surgery I), Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Suzuki
authors.affiliation: Department of General Surgical Science (Surgery I), Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Yanoma
authors.affiliation: Department of General Surgical Science (Surgery I), Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
authors.forename: Akiharu
authors.initials: A
authors.lastname: Kimura
authors.affiliation: Department of General Surgical Science (Surgery I), Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
authors.forename: Norimichi
authors.initials: N
authors.lastname: Kogure
authors.affiliation: Department of General Surgical Science (Surgery I), Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
authors.forename: Kyoichi
authors.initials: K
authors.lastname: Ogata
authors.affiliation: Department of General Surgical Science (Surgery I), Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Ohno
authors.affiliation: Department of General Surgical Science (Surgery I), Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
authors.forename: Erito
authors.initials: E
authors.lastname: Mochiki
authors.affiliation: Department of General Surgical Science (Surgery I), Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kuwano
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D004210:Dissection; D005260:Female; D005753:Gastric Mucosa / Q000601:surgery*; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000601:surgery*
keywords: Double endoscope; ESD; Early gastric cancer
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