Korean Journal of Gastrointestinal Endoscopy 2006;32(5): 326-332.
내시경 점막하 박리법을 이용한 위 종양의 치료: 점막 절개 후 올가미 절제법과 비교한 완전 절제율, 절제 시간 및 합병증
최귀숙·정훈용·최기돈·정준원·오태훈·조지윤·송호준·이진혁·변정식·명승재·양석균·김진호
울산대학교 의과대학 서울아산병원 내과학교실
Endoscopic Submucosal Dissection for Gastric Tumors: Complete Resection Rate, Resection Time and Complications in Comparison with Endoscopic Mucosal Resection after Circumferential Mucosal Incision with a Needle Knife
Kwi-Sook Choi, M.D., Hwoon-Yong Jung, M.D., Kee Don Choi, M.D., Jun-Won Chung, M.D., Tae Hoon Oh, M.D., Ji-Yun Jo, M.D., Ho June Song, M.D., Gin Hyug Lee, M.D., Jeong-Sik Byeon, M.D., Seung Jae Myung, M.D., Suk-Kyun Yang, M.D. and Jin Ho Kim, M.D.
Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
Abstract
Background/Aims: Endoscopic submucosal dissection (ESD) is a novel technique for an en bloc resection of mucosal tumors over 2 cm in diameter. The aim of this study was to evaluate the efficacy, resection time and complications of ESD using a needle knife (needle-ESD) with a comparison those encountered using endoscopic mucosal resection (EMR) after a circumferential mucosal incision with a needle knife (needle-EMR). Methods: Thirty-three consecutive patients with early gastric cancer or gastric adenoma who underwent needle-ESD at the Asan Medical Center between December 2004 and March 2005 were retrospectively reviewed, and compared with the data from 33 consecutive patients who underwent needle-EMR between March 2001 and June 2001. Results: Both the en bloc resection and complete resection could be achieved by needle-ESD in all the patients, while the corresponding percentages were 76% (en bloc resection, 25/33) and 94% (complete resection, 31/33) in the needle-EMR group. The resection time was longer (22.7 vs. 11.6 min) in the needle-ESD group than in the needle-EMR group. However, there was no significant difference in the complication rate between the two groups. Conclusions: Compared with the needle-EMR, needle-ESD has significant benefits, particularly regarding the en bloc and complete resection rate despite the technical difficulty and longer resection time. (Korean J Gastrointest Endosc 2006;32:326332)
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