Korean J Gastrointest Endosc.  2006 May;32(5):326-332.

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

  • 1Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. hyjung@amc.seoul.kr


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).
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.
Both the enbloc 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.
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.


Endoscopic mucosal resection; Endoscopic submucosal dissection; Needle knife; En bloc resection; Resection time
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