Procedure Time for Gastric Endoscopic Submucosal Dissection according to Location, considering Both Mucosal Circumferential Incision and Submucosal Dissection
Background. Previous assessments of technical difficulty and procedure time for endoscopic submucosal dissection (ESD) of gastric neoplasms did not take into account several critical determinants of these parameters. However, two key phases of ESD determine the total procedure time: the mucosal circ...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2016/9183793 |
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| author | Hironori Konuma Kenshi Matsumoto Hiroya Ueyama Hiroyuki Komori Yoichi Akazawa Misuzu Ueyama Yuta Nakagawa Takashi Morimoto Tsutomu Takeda Kohei Matsumoto Daisuke Asaoka Mariko Hojo Akihito Nagahara Takashi Yao Akihisa Miyazaki Sumio Watanabe |
| author_facet | Hironori Konuma Kenshi Matsumoto Hiroya Ueyama Hiroyuki Komori Yoichi Akazawa Misuzu Ueyama Yuta Nakagawa Takashi Morimoto Tsutomu Takeda Kohei Matsumoto Daisuke Asaoka Mariko Hojo Akihito Nagahara Takashi Yao Akihisa Miyazaki Sumio Watanabe |
| author_sort | Hironori Konuma |
| collection | DOAJ |
| description | Background. Previous assessments of technical difficulty and procedure time for endoscopic submucosal dissection (ESD) of gastric neoplasms did not take into account several critical determinants of these parameters. However, two key phases of ESD determine the total procedure time: the mucosal circumference incision speed (CIS) and submucosal dissection speed (SDS). Methods. We included 302 cases of en bloc and R0 resection of gastric neoplasms performed by 10 operators who had completed the training program at our hospital. Twelve locations were classified based on multiple criteria, such as condition of surrounding mucosa, lesion vascularity, presence of submucosal fat, ulcers, scars, fibrosis, and scope and device maneuverability. Lesions in different locations were classified into three groups based on the length of the procedure: fast, moderate, or late. Results. A significant difference was found in CIS and SDS for each location (p<0.01), which demonstrates the validity of this classification system. In several locations, CIS and SDS were not consistent with each other. Conclusion. CIS and SDS did not correspond to each other even for lesions in the same location. Consideration of ESD procedure time for gastric neoplasms requires a more elaborate classification system than that previously reported. |
| format | Article |
| id | doaj-art-8018aeba87204ddbaeb95a6163e193f6 |
| institution | Kabale University |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Gastroenterology Research and Practice |
| spelling | doaj-art-8018aeba87204ddbaeb95a6163e193f62025-02-03T07:24:51ZengWileyGastroenterology Research and Practice1687-61211687-630X2016-01-01201610.1155/2016/91837939183793Procedure Time for Gastric Endoscopic Submucosal Dissection according to Location, considering Both Mucosal Circumferential Incision and Submucosal DissectionHironori Konuma0Kenshi Matsumoto1Hiroya Ueyama2Hiroyuki Komori3Yoichi Akazawa4Misuzu Ueyama5Yuta Nakagawa6Takashi Morimoto7Tsutomu Takeda8Kohei Matsumoto9Daisuke Asaoka10Mariko Hojo11Akihito Nagahara12Takashi Yao13Akihisa Miyazaki14Sumio Watanabe15Department of Gastroenterology, Juntendo Nerima Hospital, Tokyo, JapanDepartment of Gastroenterology, Juntendo University School of Medicine, Tokyo, JapanDepartment of Gastroenterology, Juntendo University School of Medicine, Tokyo, JapanDepartment of Gastroenterology, Juntendo University School of Medicine, Tokyo, JapanDepartment of Gastroenterology, Juntendo University School of Medicine, Tokyo, JapanDepartment of Gastroenterology, Juntendo University School of Medicine, Tokyo, JapanDepartment of Gastroenterology, Juntendo University School of Medicine, Tokyo, JapanDepartment of Gastroenterology, Juntendo Nerima Hospital, Tokyo, JapanDepartment of Gastroenterology, Juntendo University School of Medicine, Tokyo, JapanDepartment of Gastroenterology, Juntendo University School of Medicine, Tokyo, JapanDepartment of Gastroenterology, Juntendo University School of Medicine, Tokyo, JapanDepartment of Gastroenterology, Juntendo University School of Medicine, Tokyo, JapanDepartment of Gastroenterology, Juntendo Sizuoka Hospital, Sizuoka, JapanDepartment of Human Pathology, Juntendo University School of Medicine, Tokyo, JapanDepartment of Gastroenterology, Juntendo Nerima Hospital, Tokyo, JapanDepartment of Gastroenterology, Juntendo University School of Medicine, Tokyo, JapanBackground. Previous assessments of technical difficulty and procedure time for endoscopic submucosal dissection (ESD) of gastric neoplasms did not take into account several critical determinants of these parameters. However, two key phases of ESD determine the total procedure time: the mucosal circumference incision speed (CIS) and submucosal dissection speed (SDS). Methods. We included 302 cases of en bloc and R0 resection of gastric neoplasms performed by 10 operators who had completed the training program at our hospital. Twelve locations were classified based on multiple criteria, such as condition of surrounding mucosa, lesion vascularity, presence of submucosal fat, ulcers, scars, fibrosis, and scope and device maneuverability. Lesions in different locations were classified into three groups based on the length of the procedure: fast, moderate, or late. Results. A significant difference was found in CIS and SDS for each location (p<0.01), which demonstrates the validity of this classification system. In several locations, CIS and SDS were not consistent with each other. Conclusion. CIS and SDS did not correspond to each other even for lesions in the same location. Consideration of ESD procedure time for gastric neoplasms requires a more elaborate classification system than that previously reported.http://dx.doi.org/10.1155/2016/9183793 |
| spellingShingle | Hironori Konuma Kenshi Matsumoto Hiroya Ueyama Hiroyuki Komori Yoichi Akazawa Misuzu Ueyama Yuta Nakagawa Takashi Morimoto Tsutomu Takeda Kohei Matsumoto Daisuke Asaoka Mariko Hojo Akihito Nagahara Takashi Yao Akihisa Miyazaki Sumio Watanabe Procedure Time for Gastric Endoscopic Submucosal Dissection according to Location, considering Both Mucosal Circumferential Incision and Submucosal Dissection Gastroenterology Research and Practice |
| title | Procedure Time for Gastric Endoscopic Submucosal Dissection according to Location, considering Both Mucosal Circumferential Incision and Submucosal Dissection |
| title_full | Procedure Time for Gastric Endoscopic Submucosal Dissection according to Location, considering Both Mucosal Circumferential Incision and Submucosal Dissection |
| title_fullStr | Procedure Time for Gastric Endoscopic Submucosal Dissection according to Location, considering Both Mucosal Circumferential Incision and Submucosal Dissection |
| title_full_unstemmed | Procedure Time for Gastric Endoscopic Submucosal Dissection according to Location, considering Both Mucosal Circumferential Incision and Submucosal Dissection |
| title_short | Procedure Time for Gastric Endoscopic Submucosal Dissection according to Location, considering Both Mucosal Circumferential Incision and Submucosal Dissection |
| title_sort | procedure time for gastric endoscopic submucosal dissection according to location considering both mucosal circumferential incision and submucosal dissection |
| url | http://dx.doi.org/10.1155/2016/9183793 |
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