Korean J Gastrointest Endosc > Volume 35(1); 2007 > Article
Korean Journal of Gastrointestinal Endoscopy 2007;35(1): 6-13.
내시경 점막절제술 후 국소 재발한 위점막 병변의 재내시경 점막절제술에 대한 연구
장재혁·이인석·유찬란·남관우·권정현·서정필·박호성·백창렬·박재명·조유경·김상우·최명규·정인식
가톨릭대학교 의과대학 내과학교실
Re-Endoscopic Mucosal Resection for a Residual or Locally Recurrent Gastric Lesion after Endoscopic Mucosal Resection
Jae Hyuck Chang, M.D., In Seok Lee, M.D., Chan Ran You, M.D., Kwan Woo Nam, M.D., Jung Hyun Kwon, M.D., Jung Pil Suh, M.D., Ho Sung Park, M.D., Chang Nyol Paik, M.D., Jae Myung Park, M.D., Yu Kyung Cho, M.D., Sang Woo Kim, M.D., Myung Gyu Choi, M.D. and I
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
Abstract

Background/Aims:
Re-endoscopic mucosal resection of a residual or locally recurrent gastric lesion after endoscopic mucosal resection (EMR) is often difficult due to submucosal fibrosis. The aim of this study was to investigate the factors related to the local recurrence of gastric lesions and the results of re-EMR.
Methods:
We retrospectively reviewed 245 patients with adenoma or early gastric cancer (EGC) treated by EMR. The factors related to local recurrence after EMR were analyzed. Ten patients with local recurrences after complete resection were treated with re-EMR and analyzed.
Results:
The mean size of the re-EMR lesions was 15.1 mm (5∼30 mm). Seven patients were treated with endoscopic submucosal dissection (ESD) and three were treated with conventional EMR. En bloc resection was performed in eight patients (80%) and complete resection was performed in nine patients (90%). Bleeding was a complication of re-EMR in five patients (50%). There was no recurrent lesion after re-EMR in nine patients over a mean follow-up duration of 14.7 months. The local recurrence rate was significantly higher when the tumor was resected piecemeal (p<0.001).
Conclusions:
Local recurrences occurred more frequently when the tumors were resected piecemeal. Re-EMR was a possible tool for the treatment of residual or locally recurrent lesions in 90% of the patients. Re-EMR may be the treatment of choice for a locally recurrent lesion after EMR according to the indication.
Key Words: Endoscopic mucosal resection, Recurrence, Endoscopic submucosal dissection
주요어: 내시경 점막절제술, 재발, 내시경 점막하 박리법
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