title: Hospital Authority audit of the outcome of endoscopic resection of superficial upper gastro-intestinal lesions in Hong Kong.
abstract: OBJECTIVE
  To review the short-term outcome of endoscopic resection of superficial upper gastro-intestinal lesions in Hong Kong.
  
  
  METHODS
  Historical cohort study.
  
  
  METHODS
  All Hospital Authority hospitals in Hong Kong.
  
  
  METHODS
  This was a multicentre retrospective study of all patients who underwent endoscopic resection of superficial upper gastro-intestinal lesions between January 2010 and June 2013 in all government-funded hospitals in Hong Kong.
  
  
  METHODS
  Indication of the procedures, peri-procedural and procedural parameters, oncological outcomes, morbidity, and mortality.
  
  
  RESULTS
  During the study period, 187 lesions in 168 patients were resected. Endoscopic mucosal resection was performed in 34 (18.2%) lesions and endoscopic submucosal dissection in 153 (81.8%) lesions. The mean size of the lesions was 2.6 (standard deviation, 1.8) cm. The 30-day morbidity rate was 14.4%, and perforations and severe bleeding occurred in 4.3% and 3.2% of the patients, respectively. Among patients who had dysplasia or carcinoma, R0 resection was achieved in 78% and the piecemeal resection rate was 11.8%. Lateral margin involvement was 14% and vertical margin involvement was 8%. Local recurrence occurred in 9% of patients and 15% had residual disease. The 2-year overall survival rate and disease-specific survival rate was 90.6% and 100%, respectively.
  
  
  CONCLUSIONS
  Endoscopic mucosal resection and endoscopic submucosal dissection were introduced in low-to-moderate-volume hospitals with acceptable morbidity rates. The short-term survival was excellent. However, other oncological outcomes were higher than those observed in high-volume centres and more secondary procedures were required.
authors.affiliation: Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong.
authors.forename: Anthony Y B
authors.initials: AY
authors.lastname: Teoh
authors.affiliation: Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong.
authors.forename: Philip W Y
authors.initials: PW
authors.lastname: Chiu
authors.affiliation: Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Hong Kong.
authors.forename: S Y
authors.initials: SY
authors.lastname: Chan
authors.affiliation: Department of Surgery, Pamela Youde Nethersole Hospital, Hong Kong.
authors.forename: Frances K Y
authors.initials: FK
authors.lastname: Cheung
authors.affiliation: Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Hong Kong.
authors.forename: K M
authors.initials: KM
authors.lastname: Chu
authors.affiliation: Department of Surgery, Queen Elizabeth Hospital, Hong Kong.
authors.forename: S S
authors.initials: SS
authors.lastname: Kao
authors.affiliation: Department of Surgery, Prince Margaret Hospital, Hong Kong.
authors.forename: T W
authors.initials: TW
authors.lastname: Lai
authors.affiliation: Department of Surgery, Yan Chai Hospital, Hong Kong.
authors.forename: C W
authors.initials: CW
authors.lastname: Lau
authors.affiliation: Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Hong Kong.
authors.forename: Simon Y K
authors.initials: SY
authors.lastname: Law
authors.affiliation: Department of Surgery, North District Hospital, Hong Kong.
authors.forename: Canice T L
authors.initials: CT
authors.lastname: Leung
authors.affiliation: Department of Medicine, Queen Marry Hospital, The University of Hong Kong, Hong Kong.
authors.forename: W K
authors.initials: WK
authors.lastname: Leung
authors.affiliation: Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Hong Kong.
authors.forename: Daniel K H
authors.initials: DK
authors.lastname: Tong
authors.affiliation: DDepartment of Surgery, United Christian Hospital, Hong Kong.
authors.forename: S H
authors.initials: SH
authors.lastname: Tsang
mesh_terms: D000236:Adenoma / Q000473:pathology / Q000601:surgery*; D000368:Aged; D016063:Blood Loss, Surgical; D002277:Carcinoma / Q000473:pathology / Q000601:surgery*; D004210:Dissection / Q000009:adverse effects; D004379:Duodenal Neoplasms / Q000473:pathology / Q000601:surgery*; D016099:Endoscopy, Gastrointestinal; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D005753:Gastric Mucosa / Q000601:surgery; D006723:Hong Kong; D006801:Humans; D007413:Intestinal Mucosa / Q000601:surgery; D007416:Intestinal Perforation / Q000209:etiology*; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D018365:Neoplasm, Residual; D019106:Postoperative Hemorrhage / Q000209:etiology*; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Endoscopy; Gastrointestinal neoplasms; Treatment outcome