Clinical Outcomes and Adverse Events of Gastric Endoscopic Submucosal Dissection of the Mid to Upper Stomach under General Anesthesia and Monitored Anesthetic Care
Background/Aims Endoscopic submucosal dissection (ESD) of gastric tumors in the mid-to-upper stomach is a technically challenging procedure. This study compared the therapeutic outcomes and adverse events of ESD of tumors in the mid-to-upper stomach performed under general anesthesia (GA) or monitor...
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| Format: | Article |
| Language: | English |
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Korean Society of Gastrointestinal Endoscopy
2022-01-01
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| Series: | Clinical Endoscopy |
| Subjects: | |
| Online Access: | http://e-ce.org/upload/pdf/ce-2021-002.pdf |
| _version_ | 1797669353332670464 |
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| author | Jong-In Chang Tae Jun Kim Na Young Hwang Insuk Sohn Yang Won Min Hyuk Lee Byung-Hoon Min Jun Haeng Lee Poong-Lyul Rhee Jae J Kim |
| author_facet | Jong-In Chang Tae Jun Kim Na Young Hwang Insuk Sohn Yang Won Min Hyuk Lee Byung-Hoon Min Jun Haeng Lee Poong-Lyul Rhee Jae J Kim |
| author_sort | Jong-In Chang |
| collection | DOAJ |
| description | Background/Aims Endoscopic submucosal dissection (ESD) of gastric tumors in the mid-to-upper stomach is a technically challenging procedure. This study compared the therapeutic outcomes and adverse events of ESD of tumors in the mid-to-upper stomach performed under general anesthesia (GA) or monitored anesthesia care (MAC). Methods Between 2012 and 2018, 674 patients underwent ESD for gastric tumors in the midbody, high body, fundus, or cardia (100 patients received GA; 574 received MAC). The outcomes of the propensity score (PS)-matched (1:1) patients receiving either GA or MAC were analyzed. Results The PS matching identified 94 patients who received GA and 94 patients who received MAC. Both groups showed high rates ofen bloc resection (GA, 95.7%; MAC, 97.9%; p=0.68) and complete resection (GA, 81.9%; MAC, 84.0%; p=0.14). There were no significant differences between the rates of adverse events (GA, 16.0%; MAC, 8.5%; p=0.18) in the anesthetic groups. Logistic regression analysis indicated that the method of anesthesia did not affect the rates of complete resection or adverse events. Conclusions ESD of tumors in the mid-to-upper stomach at our high-volume center had good outcomes, regardless of the method of anesthesia. Our results demonstrate no differences between the efficacies and safety of ESD performed under MAC and GA. |
| first_indexed | 2024-03-11T20:43:03Z |
| format | Article |
| id | doaj.art-10a05c3ca24e4f74bccc4b1c04d6558f |
| institution | Directory Open Access Journal |
| issn | 2234-2400 2234-2443 |
| language | English |
| last_indexed | 2024-03-11T20:43:03Z |
| publishDate | 2022-01-01 |
| publisher | Korean Society of Gastrointestinal Endoscopy |
| record_format | Article |
| series | Clinical Endoscopy |
| spelling | doaj.art-10a05c3ca24e4f74bccc4b1c04d6558f2023-10-02T00:33:07ZengKorean Society of Gastrointestinal EndoscopyClinical Endoscopy2234-24002234-24432022-01-01551778510.5946/ce.2021.0027550Clinical Outcomes and Adverse Events of Gastric Endoscopic Submucosal Dissection of the Mid to Upper Stomach under General Anesthesia and Monitored Anesthetic CareJong-In Chang0Tae Jun Kim1Na Young Hwang2Insuk Sohn3Yang Won Min4Hyuk Lee5Byung-Hoon Min6Jun Haeng Lee7Poong-Lyul Rhee8Jae J Kim9 Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, South Korea Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, South Korea Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South KoreaBackground/Aims Endoscopic submucosal dissection (ESD) of gastric tumors in the mid-to-upper stomach is a technically challenging procedure. This study compared the therapeutic outcomes and adverse events of ESD of tumors in the mid-to-upper stomach performed under general anesthesia (GA) or monitored anesthesia care (MAC). Methods Between 2012 and 2018, 674 patients underwent ESD for gastric tumors in the midbody, high body, fundus, or cardia (100 patients received GA; 574 received MAC). The outcomes of the propensity score (PS)-matched (1:1) patients receiving either GA or MAC were analyzed. Results The PS matching identified 94 patients who received GA and 94 patients who received MAC. Both groups showed high rates ofen bloc resection (GA, 95.7%; MAC, 97.9%; p=0.68) and complete resection (GA, 81.9%; MAC, 84.0%; p=0.14). There were no significant differences between the rates of adverse events (GA, 16.0%; MAC, 8.5%; p=0.18) in the anesthetic groups. Logistic regression analysis indicated that the method of anesthesia did not affect the rates of complete resection or adverse events. Conclusions ESD of tumors in the mid-to-upper stomach at our high-volume center had good outcomes, regardless of the method of anesthesia. Our results demonstrate no differences between the efficacies and safety of ESD performed under MAC and GA.http://e-ce.org/upload/pdf/ce-2021-002.pdfanesthesiaearly gastric cancerendoscopic submucosal dissection |
| spellingShingle | Jong-In Chang Tae Jun Kim Na Young Hwang Insuk Sohn Yang Won Min Hyuk Lee Byung-Hoon Min Jun Haeng Lee Poong-Lyul Rhee Jae J Kim Clinical Outcomes and Adverse Events of Gastric Endoscopic Submucosal Dissection of the Mid to Upper Stomach under General Anesthesia and Monitored Anesthetic Care Clinical Endoscopy anesthesia early gastric cancer endoscopic submucosal dissection |
| title | Clinical Outcomes and Adverse Events of Gastric Endoscopic Submucosal Dissection of the Mid to Upper Stomach under General Anesthesia and Monitored Anesthetic Care |
| title_full | Clinical Outcomes and Adverse Events of Gastric Endoscopic Submucosal Dissection of the Mid to Upper Stomach under General Anesthesia and Monitored Anesthetic Care |
| title_fullStr | Clinical Outcomes and Adverse Events of Gastric Endoscopic Submucosal Dissection of the Mid to Upper Stomach under General Anesthesia and Monitored Anesthetic Care |
| title_full_unstemmed | Clinical Outcomes and Adverse Events of Gastric Endoscopic Submucosal Dissection of the Mid to Upper Stomach under General Anesthesia and Monitored Anesthetic Care |
| title_short | Clinical Outcomes and Adverse Events of Gastric Endoscopic Submucosal Dissection of the Mid to Upper Stomach under General Anesthesia and Monitored Anesthetic Care |
| title_sort | clinical outcomes and adverse events of gastric endoscopic submucosal dissection of the mid to upper stomach under general anesthesia and monitored anesthetic care |
| topic | anesthesia early gastric cancer endoscopic submucosal dissection |
| url | http://e-ce.org/upload/pdf/ce-2021-002.pdf |
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