Could endoscopic resection be a suitable alternative to radical gastrectomy in management of early gastric carcinoma?

Theodor Bilharz Research Institute

Bibliographic Information

Authors: Amin M.F.; Gertallah L.M.; Abdelaziz A.M.; Abdelaziz M.; Shaker S.E.; Allam A.S.; Elbaz M.; Ghoneme M.; Sherbiny M.; Sharaf A.L.; Harb O.A.; Mohamed A.H.; Kalmoush A.-E.

Journal: Surgical Chronicles

Publisher: Surgical Society of Northern Greece

Publication Date: 2024

Volume / Issue: Volume 29 / Issue 4

Pages: 425–431

ISSN: 11085002

Scopus: View on Scopus

Document Type: Article

Authors and Affiliations

Amin M.F., Department of General Surgery, Faculty of Medicine, Zagazig University, Egypt; Gertallah L.M., Department of General Surgery, Faculty of Medicine, Zagazig University, Egypt; Abdelaziz A.M., Department of General Surgery, Faculty of Medicine, Zagazig University, Egypt; Abdelaziz M., Department of General Surgery, Surgical Oncology, Oncology Center, Mansura University, Egypt; Shaker S.E., Department of Internal Medicine, Faculty of Medicine, Zagazig University, Egypt; Allam A.S., Department of Internal Medicine, Faculty of Medicine, Zagazig University, Egypt; Elbaz M., Department of Internal Medicine, Faculty of Medicine, Cairo University, Egypt; Ghoneme M., Department of hepatogastroenterology and Infectious Diseases, Faculty of Medicine, Alazhar University, Egypt; Sherbiny M., Department of Hepatology and Gastroenterology, Theodor Bilharz, Research Institute, Egypt; Sharaf A.L., Department of Tropical Medicine, Faculty of Medicine, Zagazig University, Egypt; Harb O.A., Department of Pathology, Faculty of Medicine, Zagazig University, Egypt; Mohamed A.H., Department of Pathology, Faculty of Medicine, Zagazig University, Egypt; Kalmoush A.-E., Department of General Surgery, Faculty of Medicine, Alazhar University, Egypt

Abstract

Background: There are many management strategies of early gastric carcinoma as; endoscopic sub-mucosal dissection or endoscopic mucosal resection, open radical gastrectomy and laparoscopic radical gastrectomy. Each management strategies was found to have benefits and drawbacks with no consensus reached and there are only few comparative studies were reported in this topic. Aim of the current study was to compare between endoscopic submucosal dissection or endoscopic mucosal resection, open radical gastrectomy and laparoscopic radical gastrectomy as management strategies for early gastric carcinoma regarding advantages, operative, perioperative findings, short term and long term outcomes and patients prognosis. Patients and methods: We included a total of 350 patients with gastric carcinoma. We divided included patients into 3 groups according to used management approach, ESD/EMR group (100), LARG group (91), and ORG group (159). We followed patients for about 5 years with a median follow-up of 22 months for assessment of short term outcomes, long term postoperative complications, post-operative recurrence, 5-year overall survival (OS) rate and disease-free survival (DFS). Results: Patients with intra-mucosal carcinoma were more in the group of patients underwent ESD/EMR group than that in the other groups (P = 0.003). Duration of hospital stay, time of postoperative fluid intake, and antibiotic use in the group of patients underwent ESD/EMR were lower than those in patients underwent LARG group and ORG (P < 0.05). 5-year survival rates in the group of patients underwent ESD/EMR were less than patients underwent LARG or ORG group. Absent lymphovascular invasion, conventional adenocarcinoma protect against recurrence after ESD/EMR. Conclusion: ESD/EMR is associated with less surgical trauma to tissues, rabid recovery, better life quality, and less cost, but it was associated with higher risk of lymph node metastasis. So, LARG/ORG is still superior to ESD/EMR for management of EGC patients regarding radicality of management, better survival rates and less risk of lymph nodes metastases. © 2024 Surgical Society of Northern Greece. All rights reserved.

Keywords

early gastric carcinoma; ESD/EMR; ORG/LARG

Citation Information

Scopus Citations: 0

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