RESUMEN
INTRODUCTION AND AIMS: Endoscopic submucosal dissection (ESD) in the treatment of superficial neoplasias of the gastrointestinal tract is currently one of the greatest advances in therapeutic endoscopy. Due to its high technical complexity, it is not yet a routine procedure in Latin America. The aim of the present study was to present the experience in Brazil with ESD in superficial gastric neoplasias, based on training received from Japanese experts. MATERIALS AND METHODS: A retrospective study was conducted, in which information was prospectively collected from a database that included all patients that underwent ESD due to superficial gastric neoplasias at two endoscopy referral centers in Brazil, within the time frame of June 2008 to June 2019. En bloc, complete, and curative resection rates were calculated, along with the local recurrence rate and adverse events. RESULTS: A total of 103 ESDs for superficial gastric neoplasias were performed during the study period. Eighty of those patients (77.6%) presented with early malignant gastric neoplasias or premalignant lesions (adenocarcinoma: 52.5%, high-grade dysplasia: 27.5%, low-grade dysplasia: 16.3%, and neuroendocrine tumors: 3.8%). Overall en bloc and complete resection rates for the superficial gastric neoplasias were 96.3% and 92.5%, respectively, whereas the curative resection rate based on expanded criteria was 76%. CONCLUSIONS: ESD for the treatment of superficial gastric neoplasias is a safe and effective therapeutic modality in Latin America, with results similar to those shown in the most representative Japanese studies.
Asunto(s)
Resección Endoscópica de la Mucosa , Brasil , Resección Endoscópica de la Mucosa/efectos adversos , Hospitales , Humanos , Japón , Recurrencia Local de Neoplasia , Derivación y Consulta , República de Corea , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
RESUMEN La Organización Mundial de la Salud señala que el cáncer gástrico es una neoplasia frecuente en el mundo contemporáneo. Constituye la segunda causa de muerte en el hombre y la tercera en las mujeres. Numerosos son los factores de riesgo que se asocian con la aparición del cáncer gástrico, en determinadas regiones del mundo. El descubrimiento del Helicobacter pylori y la asociación con las enfermedades gastroduodenales ha revolucionado los aspectos fisiopatológicos y terapéuticos hasta el punto de considerar la bacteria como agente precursor del cáncer gástrico. Por tal motivo se realizó una revisión de los factores de riesgo y el papel del Helicobacter pylori en la formación de la neoplasia gástrica, con el objetivo de aportar conocimientos relacionados con el cáncer gástrico y su prevención (AU).
ABSTRACT The World Health Organization points out that gastric cancer is a frequent neoplasia in the contemporary world. It is the second cause of death in men and the third one in women. There are several risk factors associated to the development of gastric cancer in specific regions of the world. The discovery of Helicobacter pylori and its association to gastro duodenal diseases has renewed the physiopathological and therapeutic aspects up to the point of considering the bacteria as precursor agent of gastric cancer. For that cause, it was carried out a review of the risk factors and the role of Helicobacter pylori in the formation of gastric neoplasia, with the objective of giving out knowledge related to gastric cancer and its prevention (AU).
Asunto(s)
Humanos , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/mortalidad , Neoplasias Gástricas/prevención & control , Neoplasias Gástricas/epidemiología , Factores de Riesgo , Infecciones por Helicobacter/complicaciones , Infecciones por Helicobacter/etiología , Infecciones por Helicobacter/epidemiología , Servicios Preventivos de Salud , Bibliografía de Medicina , Países Desarrollados , Indicadores de Morbimortalidad , Métodos Epidemiológicos , Helicobacter pylori , Países en Desarrollo , Promoción de la SaludRESUMEN
RESUMEN La Organización Mundial de la Salud señala que el cáncer gástrico es una neoplasia frecuente en el mundo contemporáneo. Constituye la segunda causa de muerte en el hombre y la tercera en las mujeres. Numerosos son los factores de riesgo que se asocian con la aparición del cáncer gástrico, en determinadas regiones del mundo. El descubrimiento del Helicobacter pylori y la asociación con las enfermedades gastroduodenales ha revolucionado los aspectos fisiopatológicos y terapéuticos hasta el punto de considerar la bacteria como agente precursor del cáncer gástrico. Por tal motivo se realizó una revisión de los factores de riesgo y el papel del Helicobacter pylori en la formación de la neoplasia gástrica, con el objetivo de aportar conocimientos relacionados con el cáncer gástrico y su prevención (AU).
ABSTRACT The World Health Organization points out that gastric cancer is a frequent neoplasia in the contemporary world. It is the second cause of death in men and the third one in women. There are several risk factors associated to the development of gastric cancer in specific regions of the world. The discovery of Helicobacter pylori and its association to gastro duodenal diseases has renewed the physiopathological and therapeutic aspects up to the point of considering the bacteria as precursor agent of gastric cancer. For that cause, it was carried out a review of the risk factors and the role of Helicobacter pylori in the formation of gastric neoplasia, with the objective of giving out knowledge related to gastric cancer and its prevention (AU).
Asunto(s)
Humanos , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/mortalidad , Neoplasias Gástricas/prevención & control , Neoplasias Gástricas/epidemiología , Factores de Riesgo , Infecciones por Helicobacter/complicaciones , Infecciones por Helicobacter/etiología , Infecciones por Helicobacter/epidemiología , Servicios Preventivos de Salud , Bibliografía de Medicina , Países Desarrollados , Indicadores de Morbimortalidad , Métodos Epidemiológicos , Helicobacter pylori , Países en Desarrollo , Promoción de la SaludRESUMEN
Introduction: The endoscopic submucosal dissection (ESD) is a technique used in the treatment of early gastric cancer that was developed in Japan in the early 90's. When compared with mucosectomy it shows clear benefits, as lower local recurrence with the resection of lesions greater than 2 cm, yet with larger number of complications, especially bleeding and perforation. There is little experience with ESD in the West, because of the low incidence of early gastric cancer and the lack of screening programs; ESD reports are scarce in Colombia. Objective: To report the experience with the endoscopic dissection of the gastric submucosa in the period between March 2012 and January 2014 at Hospital de San José, Bogotá, Colombia. Methods: ESD was performed in eight patients (four men and four women) that fulfilled the Vienna criteria for this procedure. Results: Eight ESD were performed, three in the body and five in the antrum, with a mean size of 3.4 cm; complications included bleeding in one patient and perforation in one patient. En bloc resection was achieved in all eight cases with R0 (margins free of tumor) in seven patients. Conclusion: Gastric ESD is a complex technique and infrequent technique in our evironment. The procedure was performed in a safe manner with acceptable complication rates and achieving en bloc resection in all patients.
Introduction: The endoscopic submucosal dissection (ESD) is a technique used in the treatment of early gastric cancer that was developed in Japan in the early 90's. When compared with mucosectomy it shows clear benefits, as lower local recurrence with the resection of lesions greater than 2 cm, yet with larger number of complications, especially bleeding and perforation. There is little experience with ESD in the West, because of the low incidence of early gastric cancer and the lack of screening programs; ESD reports are scarce in Colombia. Objective: To report the experience with the endoscopic dissection of the gastric submucosa in the period between March 2012 and January 2014 at Hospital de San José, Bogotá, Colombia. Methods: ESD was performed in eight patients (four men and four women) that fulfilled the Vienna criteria for this procedure. Results: Eight ESD were performed, three in the body and five in the antrum, with a mean size of 3.4 cm; complications included bleeding in one patient and perforation in one patient. En bloc resection was achieved in all eight cases with R0 (margins free of tumor) in seven patients. Conclusion: Gastric ESD is a complex technique and infrequent technique in our evironment. The procedure was performed in a safe manner with acceptable complication rates and achieving en bloc resection in all patients.