title: Precordial skin burns after endoscopic submucosal dissection for gastric tube cancer.
abstract: OBJECTIVE
  Endoscopic submucosal dissection (ESD) is useful as a minimally invasive treatment option for early gastric cancer. ESD is also used in the management of postoperative remnant gastric cancers in the stomach and gastric tube cancers. Perforation and delayed bleeding have been the main complications of ESD reported in the management of gastric tube cancer. However, in the current literature, there is no description of precordial skin burns caused by electrical coagulation.
  
  
  METHODS
  While we treated 22 patients with gastric tube cancers by ESD from 2005 to 2014, we experienced five skin burns in four patients after ESD. We retrospectively analyzed clinical characteristics of precordial skin burn as a complication of ESD.
  
  
  RESULTS
  All skin burns occurred in patients reconstructed using a presternal route, whose incidence of precordial skin burn was 55.6%. In all cases, lesions were located in the upper or middle third of gastric tubes irrespective of their direction. Skin burn developed on postoperative day (POD) 1 or POD 2, taking 4-7 days to heal and was accompanied by high fever in 60% of cases.
  
  
  CONCLUSIONS
  The present study suggests that when carrying out ESD for gastric tube cancer using the presternal route, it is necessary to consider the occurrence of a precordial skin burn as a possible complication.
authors.affiliation: Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
authors.forename: Motoshi
authors.initials: M
authors.lastname: Miyagi
authors.affiliation: Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Yoshio
authors.affiliation: Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Hirasawa
authors.affiliation: Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Ishiyama
authors.affiliation: Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
authors.forename: Yorimasa
authors.initials: Y
authors.lastname: Yamamoto
authors.affiliation: Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Tsuchida
authors.affiliation: Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
authors.forename: Junko
authors.initials: J
authors.lastname: Fujisaki
authors.affiliation: Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Igarashi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002058:Burns, Electric / Q000209:etiology* / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery; D004210:Dissection / Q000009:adverse effects* / Q000379:methods; D004564:Electrocoagulation / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D005753:Gastric Mucosa / Q000601:surgery*; D005773:Gastroscopy / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D012867:Skin / Q000293:injuries / Q000473:pathology; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*
keywords: endoscopic submucosal dissection; gastric tube cancer; presternal route reconstruction; skin burn; thermal injury