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Clinical Outcomes and Adverse Events of Gastric Endoscopic Submucosal Dissection of the Mid to Upper Stomach under General Anesthesia and Monitored Anesthetic Care
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Jong-In Chang, Tae Jun Kim, Na Young Hwang, Insuk Sohn, Yang Won Min, Hyuk Lee, Byung-Hoon Min, Jun Haeng Lee, Poong-Lyul Rhee, Jae J Kim
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Clin Endosc 2022;55(1):77-85. Published online July 5, 2021
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DOI: https://doi.org/10.5946/ce.2021.002
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 Abstract
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- Background
/Aims: Endoscopic submucosal dissection (ESD) of gastric tumors in the mid-to-upper stomach is a technically challenging procedure. This study compared the therapeutic outcomes and adverse events of ESD of tumors in the mid-to-upper stomach performed under general anesthesia (GA) or monitored anesthesia care (MAC).
Methods
Between 2012 and 2018, 674 patients underwent ESD for gastric tumors in the midbody, high body, fundus, or cardia (100 patients received GA; 574 received MAC). The outcomes of the propensity score (PS)-matched (1:1) patients receiving either GA or MAC were analyzed.
Results
The PS matching identified 94 patients who received GA and 94 patients who received MAC. Both groups showed high rates of en bloc resection (GA, 95.7%; MAC, 97.9%; p=0.68) and complete resection (GA, 81.9%; MAC, 84.0%; p=0.14). There were no significant differences between the rates of adverse events (GA, 16.0%; MAC, 8.5%; p=0.18) in the anesthetic groups. Logistic regression analysis indicated that the method of anesthesia did not affect the rates of complete resection or adverse events.
Conclusions
ESD of tumors in the mid-to-upper stomach at our high-volume center had good outcomes, regardless of the method of anesthesia. Our results demonstrate no differences between the efficacies and safety of ESD performed under MAC and GA.
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Citations
Citations to this article as recorded by  - Efficacy, safety, and impact on procedural outcomes of local anesthesia in endoscopic submucosal dissection: a systematic review and meta-analysis
Hazem Abosheaishaa, Abdelmalek Abdelghany, Abdallfatah Abdallfatah, Doha Mohamed, Ammar Ayman Bahbah, Islam Mohamed, Khaled Elfert, Ahmed E. Salem, Azizullah Beran, Ahmad Madkour, Mohammad Al-Haddad
Baylor University Medical Center Proceedings.2024; 37(6): 963. CrossRef - General Anesthesia and Endoscopic Upper Gastrointestinal Tumor Resection
Seung Hyun Kim
Journal of Digestive Cancer Research.2023; 11(3): 125. CrossRef - Is General Anesthesia Needed in Endoscopic Submucosal Dissection for Lesions Located in the Mid to Upper Stomach?
Prasit Mahawongkajit, Jirawat Swangsri
Clinical Endoscopy.2022; 55(1): 43. CrossRef - Therapeutic approach to non-curative resection after endoscopic treatment in early gastric cancer
Eun Jeong Gong, Chang Seok Bang
Journal of the Korean Medical Association.2022; 65(5): 284. CrossRef - Paneth Cell Carcinoma of the Stomach
Jun Wan Kim, Gwang Ha Kim, Kyung Bin Kim
The Korean Journal of Gastroenterology.2022; 80(1): 34. CrossRef - Comparing Different Anesthesia Methods on Anesthetic Effect and Postoperative Pain in Patients with Early Gastric Cancer during Endoscopic Submucosal Dissection
Jie Zhang, Yanlei Chen, Zhiwu Liu, Zhihao Pan, Jinghua Pan
Journal of Oncology.2022; 2022: 1. CrossRef
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