Endoscopic causes and characteristics of missed gastric cancers after endoscopic submucosal dissection.
Because endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) preserves the entire stomach, missed gastric cancers (MGCs) are often found in the remaining gastric mucosa. However, the endoscopic causes of MGCs remain unclear. Therefore, we aimed to elucidate the endoscopic causes and...
| Publicado en: | Gastrointestinal Endoscopy Vol. 98; no. 5; pp. 735 - 736 |
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| Autores principales: | , , , , , , , , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Elsevier B.V.
Nov2023
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=173050872&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 173050872 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00165107 4A9 jtl: Gastrointestinal Endoscopy issn: 00165107 maglogo: N pubinfo: dt: Nov2023 vid: 98 iid: 5 pid: 467 pub: Elsevier B.V. place: New York, New York artinfo: ui: 173050872 173050872 173050872 10.1016/j.gie.2023.02.024 173050872 ppf: 735 ppct: 1 formats: tig: atl: Endoscopic causes and characteristics of missed gastric cancers after endoscopic submucosal dissection. aug: au: Shimada, Seitaro Yabuuchi, Yohei Kawata, Noboru Maeda, Yuki Yoshida, Masao Yamamoto, Yoichi Minamide, Tatsunori Shigeta, Kohei Takada, Kazunori Kishida, Yoshihiro Ito, Sayo Imai, Kenichiro Hotta, Kinichi Ishiwatari, Hirotoshi Matsubayashi, Hiroyuki Ono, Hiroyuki affil: Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan sug: subj: Endoscopy, Gastrointestinal Stomach Neoplasms Diagnosis Failure to Diagnose Gastric Mucosa Surgery Stomach Neoplasms Surgery Intraoperative Monitoring Human Retrospective Design Record Review Cancer Patients Logistic Regression Surgical Patients Descriptive Statistics Odds Ratio Confidence Intervals Stomach Pathology Pyloric Antrum Pathology ab: Because endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) preserves the entire stomach, missed gastric cancers (MGCs) are often found in the remaining gastric mucosa. However, the endoscopic causes of MGCs remain unclear. Therefore, we aimed to elucidate the endoscopic causes and characteristics of MGCs after ESD. From January 2009 to December 2018, all patients undergoing ESD for initially detected EGC were enrolled. According to a review of EGD images before ESD, we identified the endoscopic causes (perceptual, exposure, sampling errors, and inadequate preparation) and characteristics of MGC in each endoscopic cause. Of 2208 patients who underwent ESD for initial EGC, 82 patients (3.7%) had 100 MGCs. The breakdown of endoscopic causes of MGCs was as follows: 69 (69%) perceptual errors, 23 (23%) exposure errors, 7 (7%) sampling errors, and 1 (1%) inadequate preparation. Logistic regression analysis showed that the risk factors for perceptual error were male sex (odds ratio [OR], 2.45; 95% confidence interval [CI], 1.16-5.18), isochromatic coloration (OR, 3.17; 95% CI, 1.47-6.84), greater curvature (OR, 2.31; 95% CI, 1.121-4.40), and lesion size ≤12 mm (OR, 1.74; 95% CI, 1.07-2.84). The sites of exposure errors were around the incisura angularis (11 [48%]), posterior wall of the gastric body (6 [26%]), and antrum (5 [21%]). We identified MGCs in 4 categories and clarified their characteristics. Quality improvements in EGD observation, with attention to the risks of perceptual and site of exposure errors, can potentially prevent missing EGCs. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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