Endoscopic treatment of patients with early forms of gastric cancer

Abstract

Background: Currently, most patients with gastric tumors are detected in late stages. Early diagnosis is a major factor in improving treatment outcomes. On the other hand, patients who are diagnosed on early stages often receive aggressive treatment and are not subjects to less invasive interventions. Material and Methods: In our clinic we have been using endoscopic surgery for early gastric cancer since 2009. Japanese colleagues are the most experienced in this kind of treatment that is why we follow the recommendations of Japanese Gastric Cancer Association (JGCA). The main criterion provided that endoscopic removal is possible is the depth of tumor invasion. We evaluate the depth of invasion primarily by endoscopic ultrasonography. According to our data the accuracy of this method is 94%. The main operation used for the treatment of early gastric cancer is endoscopic submucosal dissection (ESD). Its main advantages are single block resection within healthy tissues and adequate morphological assessment of the removed tumor. In the last ten years we have performed 148 ESD (145 patients) for early forms of gastric cancer. Surgeries were radical in 95% of cases. Results:There were no cases of postoperative mortality. Progression of the disease was noted only in one patient. These endoscopic surgeries have proved to be effective, safe and reasonable in treating early gastric cancer. Conclusions: Thus, endoscopic surgery significantly reduces the cost of treatment and hospital stay (average - 3.7 days), facilitates rehabilitation and improves the quality of patients’ life.