Is endoscopic mucosal resection a sufficient treatment for low-grade gastric epithelial dysplasia?

Content Provider	Europe PMC
Author	Kim, Seul Young Sung, Jae Kue Moon, Hee Seok Kim, Kyu Seop Jung, Il Soon Yoon, Beom Yong Kim, Beom Hee Ko, Kwang Hun Jeong, Hyun Yong
Copyright Year	2012
Abstract	Background/AimsThe rate of diagnosis of gastric adenoma has increased because esophagogastroduodenoscopy is being performed at an increasingly greater frequency. However, there are no treatment guidelines for low-grade dysplasia (LGD). To determine the appropriate treatment for LGD, we evaluated the risk factors associated with the categorical upgrade from LGD to high grade dysplasia (HGD)/early gastric cancer (EGC) and the risk factors for recurrence after endoscopic treatment.MethodsWe compared the complication rates, recurrence rates, and remnant lesions in 196 and 56 patients treated with endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR), respectively, by histologically confi rming low-grade gastric epithelial dysplasia.ResultsThe en bloc resection rate was significantly lower in the EMR group (31.1%) compared with the ESD group (75.0%) (p<0.001). However, no significant difference was observed in the prevalence of remnant lesions or recurrence rate (p=0.911) of gastric adenoma. The progression of LGD to HGD or EGC caused an increase in the incidence of tumor lesions >1 cm with surface redness and depressions.ConclusionsFor the treatment of LGD, EMR resulted in a higher incidence of uncertain resection margins and a lower en bloc resection rate than ESD. However, there was no signifi cant difference in recurrence rate.
ISSN	19762283
Journal	Gut and Liver
Volume Number	6
PubMed Central reference number	PMC3493724
Issue Number	4
PubMed reference number	23170148
e-ISSN	20051212
DOI	10.5009/gnl.2012.6.4.446
Language	English
Publisher	The Korean Society of Gastroenterology; the Korean Society of Gastrointestinal Endoscopy; the Korean Association for the Study of the Liver; the Korean Society of Neurogastroenterology and Motility; Korean Association for the Study of Intestinal Diseases; Korean College of Helicobacter and Upper Gastrointestinal Research; Korean Pancreatobiliary Association; Korean Society of Gastrointestinal Cancer
Publisher Date	2012-10-18
Access Restriction	Open
Rights License	This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright © 2012 by the Korean Society of Gastroenterology, the Korean Society of Gastrointestinal Endoscopy, the Korean Society of Neurogastroenterology and Motility, Korean College of Helicobacter and Upper Gastrointestinal Research, Korean Association for the Study of Intestinal Diseases, the Korean Association for the Study of the Liver, Korean Pancreatobiliary Association, and Korean Society of Gastrointestinal Cancer
Subject Keyword	Adenoma Low-grade dysplasia Endoscopic mucosal resection Endoscopic submucosal dissection
Content Type	Text
Resource Type	Article
Subject	Hepatology Gastroenterology