caa a22 4500 445888296 CHVBK 20180317145607.0 cr unu---uuuuu 170323e20110301xx s 000 0 eng 10.1007/s00535-010-0350-1 doi (NATIONALLICENCE)springer-10.1007/s00535-010-0350-1 Endoscopic submucosal dissection as a treatment for gastric noninvasive neoplasia: a multicenter study by Osaka University ESD Study Group [Elektronische Daten] [Motohiko Kato, Tsutomu Nishida, Shusaku Tsutsui, Masato Komori, Tomoki Michida, Katsumi Yamamoto, Naoki Kawai, Shinji Kitamura, Shinichiro Zushi, Akihiro Nishihara, Fumihiko Nakanishi, Kazuo Kinoshita, Takuya Yamada, Hideki Iijima, Masahiko Tsujii, Norio Hayashi] Background: Treatment with endoscopic submucosal dissection (ESD) for gastric noninvasive neoplasia (NIN) diagnosed by endoscopic forceps biopsy specimen, whether as a follow-up or "total incisional biopsy”, is controversial. To validate the use of ESD for total incisional biopsy in NIN, we examined the underdiagnosis rate of NIN and the rates of complication associated with ESD. Methods: This is a cross-sectional multicenter retrospective study from 10 hospitals. Subjects diagnosed with NIN (equivalent to category 3 or 4.1 of the Vienna classification) by endoscopic forceps biopsy and treated with ESD were included. From March 2003 to December 2009, a total of 468 subjects were included and analyzed. The underdiagnosis rate was defined as the proportion of lesions diagnosed with adenocarcinoma after ESD. We assessed the complete en-bloc resection rate and the complication rate of ESD. Results: Among the 468 subjects with NIN, 205 were diagnosed with adenocarcinoma after ESD, with an underdiagnosis rate of 44% (95% confidence interval: 39-49%). Two submucosal cancer lesions had invaded beyond 500μm and one had lymphatic involvement. The complete en-bloc resection rate was 97%. The incidences of post-ESD bleeding, perforation, and serious complications were 5.5, 4.7, and 0.43%, respectively. There were no procedure-related deaths. Conclusions: In this large-scale, multicenter cross-sectional study, over 40% of the noninvasive gastric neoplasia specimens were determined to have adenocarcinoma, and the ESD-related complication rate was relatively low. Therefore, ESD was useful and may be a therapeutic option for gastric NIN. Springer, 2010 Gastric nationallicence Noninvasive neoplasia nationallicence Adenoma nationallicence ESD nationallicence EMR : Endoscopic mucosal resection nationallicence ESD : Endoscopic submucosal dissection nationallicence NBI : Narrow band imaging nationallicence NIN : Noninvasive neoplasia nationallicence Kato Motohiko Department of Gastroenterology and Hepatology, Clinical Research Building (K1), Osaka University Graduate School of Medicine, 2-2 Yamadaoka, 565-0871, Suita, Osaka, Japan aut Nishida Tsutomu Department of Gastroenterology and Hepatology, Clinical Research Building (K1), Osaka University Graduate School of Medicine, 2-2 Yamadaoka, 565-0871, Suita, Osaka, Japan aut Tsutsui Shusaku Department of Gastroenterology and Hepatology, Clinical Research Building (K1), Osaka University Graduate School of Medicine, 2-2 Yamadaoka, 565-0871, Suita, Osaka, Japan aut Komori Masato Department of Gastroenterology, Kansai Rosai Hospital, Hyogo, Japan aut Michida Tomoki Department of Gastroenterology, Osaka Kosei-Nenkin Hospital, Osaka, Japan aut Yamamoto Katsumi Department of Gastroenterology, Toyonaka Municipal Hospital, Toyonaka, Japan aut Kawai Naoki Department of Gastroenterology, Osaka Police Hospital, Osaka, Japan aut Kitamura Shinji Department of Gastroenterology, Sakai Municipal Hospital, Sakai, Japan aut Zushi Shinichiro Department of Gastroenterology, Ikeda Municipal Hospital, Ikeda, Japan aut Nishihara Akihiro Department of Gastroenterology, Minoh City Hospital, Minoh, Japan aut Nakanishi Fumihiko Department of Gastroenterology, Osaka Minami Medical Center, National Hospital Organization, Osaka, Japan aut Kinoshita Kazuo Department of Gastroenterology, Sumitomo Hospital, Osaka, Japan aut Yamada Takuya Department of Gastroenterology and Hepatology, Clinical Research Building (K1), Osaka University Graduate School of Medicine, 2-2 Yamadaoka, 565-0871, Suita, Osaka, Japan aut Iijima Hideki Department of Gastroenterology and Hepatology, Clinical Research Building (K1), Osaka University Graduate School of Medicine, 2-2 Yamadaoka, 565-0871, Suita, Osaka, Japan aut Tsujii Masahiko Department of Gastroenterology and Hepatology, Clinical Research Building (K1), Osaka University Graduate School of Medicine, 2-2 Yamadaoka, 565-0871, Suita, Osaka, Japan aut Hayashi Norio Department of Gastroenterology and Hepatology, Clinical Research Building (K1), Osaka University Graduate School of Medicine, 2-2 Yamadaoka, 565-0871, Suita, Osaka, Japan aut Journal of Gastroenterology Springer Japan 46/3(2011-03-01), 325-331 0944-1174 46:3<325 2011 46 535 https://doi.org/10.1007/s00535-010-0350-1 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00535-010-0350-1 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kato Motohiko Department of Gastroenterology and Hepatology, Clinical Research Building (K1), Osaka University Graduate School of Medicine, 2-2 Yamadaoka, 565-0871, Suita, Osaka, Japan aut NATIONALLICENCE 700 1- Nishida Tsutomu Department of Gastroenterology and Hepatology, Clinical Research Building (K1), Osaka University Graduate School of Medicine, 2-2 Yamadaoka, 565-0871, Suita, Osaka, Japan aut NATIONALLICENCE 700 1- Tsutsui Shusaku Department of Gastroenterology and Hepatology, Clinical Research Building (K1), Osaka University Graduate School of Medicine, 2-2 Yamadaoka, 565-0871, Suita, Osaka, Japan aut NATIONALLICENCE 700 1- Komori Masato Department of Gastroenterology, Kansai Rosai Hospital, Hyogo, Japan aut NATIONALLICENCE 700 1- Michida Tomoki Department of Gastroenterology, Osaka Kosei-Nenkin Hospital, Osaka, Japan aut NATIONALLICENCE 700 1- Yamamoto Katsumi Department of Gastroenterology, Toyonaka Municipal Hospital, Toyonaka, Japan aut NATIONALLICENCE 700 1- Kawai Naoki Department of Gastroenterology, Osaka Police Hospital, Osaka, Japan aut NATIONALLICENCE 700 1- Kitamura Shinji Department of Gastroenterology, Sakai Municipal Hospital, Sakai, Japan aut NATIONALLICENCE 700 1- Zushi Shinichiro Department of Gastroenterology, Ikeda Municipal Hospital, Ikeda, Japan aut NATIONALLICENCE 700 1- Nishihara Akihiro Department of Gastroenterology, Minoh City Hospital, Minoh, Japan aut NATIONALLICENCE 700 1- Nakanishi Fumihiko Department of Gastroenterology, Osaka Minami Medical Center, National Hospital Organization, Osaka, Japan aut NATIONALLICENCE 700 1- Kinoshita Kazuo Department of Gastroenterology, Sumitomo Hospital, Osaka, Japan aut NATIONALLICENCE 700 1- Yamada Takuya Department of Gastroenterology and Hepatology, Clinical Research Building (K1), Osaka University Graduate School of Medicine, 2-2 Yamadaoka, 565-0871, Suita, Osaka, Japan aut NATIONALLICENCE 700 1- Iijima Hideki Department of Gastroenterology and Hepatology, Clinical Research Building (K1), Osaka University Graduate School of Medicine, 2-2 Yamadaoka, 565-0871, Suita, Osaka, Japan aut NATIONALLICENCE 700 1- Tsujii Masahiko Department of Gastroenterology and Hepatology, Clinical Research Building (K1), Osaka University Graduate School of Medicine, 2-2 Yamadaoka, 565-0871, Suita, Osaka, Japan aut NATIONALLICENCE 700 1- Hayashi Norio Department of Gastroenterology and Hepatology, Clinical Research Building (K1), Osaka University Graduate School of Medicine, 2-2 Yamadaoka, 565-0871, Suita, Osaka, Japan aut NATIONALLICENCE 773 0- Journal of Gastroenterology Springer Japan 46/3(2011-03-01), 325-331 0944-1174 46:3<325 2011 46 535 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer