Risk factors for incomplete resection in ESD for precancerous lesions and early cancer in upper digestive tract / 中华消化内镜杂志

ABSTRACT

Objective To explore the reasons for lateral and basal incomplete resection of precancerous lesions or cancer from upper digestive tract by endoscopic submucosal dissection (ESD).Methods Data of 295 patients undergoing ESD for upper gastrointestinal precancerous lesions or cancer from November 2006 to October 2011 were collected,and reasons of basal or lateral incomplete resectin confirmed by postESD pathology were analyzed.Results The total incomplete resection rate after ESD was 3.05％ ( 9/295 ).Among 95 cases of esophageal ESD,there was 1 case of lateral margin incomplete resection because of the retraction of normal tissue after dissection.Among 200 cases of gastric ESD,there were 5 cases of lateral margin incomplete resection,in which 2 cases were signet ring carcinoma with submucosal infiltration and spreading,2 were due to retraction of normal tissue after dissection,and 1 was due to inaccurate judgment on cancer demarcation.There were 3 cases of basal incomplete resectin in gastric ESD,which was caused by incorrecte invasion depth estimation before ESD.Conclusion The rate of basal or lateral incomplete resection in upper gastrointestinal ESD was low,which is related to pathological type,ESD procedure and estimation of invasion depth before ESD.