Complications of Endoscopic Submucosal Dissection in Patients with Superficial Gastric Neoplasias

Abstract

The aim of this study was to evaluate the complications of endoscopic submucosal dissection (ESD) in patients with superficial gastric neoplasias. Two hundred and fifty patients with 269 lesions due to early gastric cancer or gastric adenoma were enrolled ; 187 lesions were in patients under 75 years of age (younger group) and 82 were in patients of 75 years of age or older (elderly group). The mean size of lesions in the elderly group (17.0mm) was significantly larger than that in the younger group (14.0mm). The mean time of the ESD procedure in the elderly group (58.2minutes) was significantly longer than that in the younger group (47.2minutes). Bleeding after ESD occurred in 15 lesions out of 269 (5.6%), the mean size of which was significantly larger (20.4mm) than lesions which had no bleeding (14.5mm). Lesions in the upper third, middle, and lower portion occurred in 2 of 31 lesions (6.5%), 3 of 105 lesions (2.9%) and 10 of 133 lesions (7.5%). The rate of bleeding after ESD in the elderly group (2.6%) was significantly lower than that in the younger group (8.0%). Perforation occurred in two patients (0.7%), who were both in the younger group. Fever after ESD occurred in 2 patients and severe bradycardia during ESD occurred in one patient. ESD thus seems to be safe for patients with superficial gastric neoplasias if their general condition and comorbid illness is carefully managed not only during, but also before and after ESD.