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Clinical features and outcomes of delayed perforation after endoscopic submucosal dissection for early gastric cancer

2010; Thieme Medical Publishers (Germany); Volume: 42; Issue: 12 Linguagem: Inglês

10.1055/s-0030-1255932

1438-8812

Noboru Hanaoka, Noriya Uedo, Ryu Ishihara, K Higashino, Yoji Takeuchi, Takuya Inoue, Rika Chatani, Masao Hanafusa, Yoshiki Tsujii, Hiromitsu Kanzaki, Natsuko Kawada, Hiroyasu Iishi, Masaharu Tatsuta, Yasuhiko Tomita, Isao Miyashiro, M Yano,

Gastrointestinal Tumor Research and Treatment

Perforation is a major complication of endoscopic submucosal dissection (ESD) for early gastric cancer (EGC). However, there have been no reports on delayed perforation after ESD for EGC. We aimed to elucidate the incidence and outcomes of delayed perforation after ESD. Clinical courses in 1159 consecutive patients with 1329 EGCs who underwent ESD were investigated. Delayed perforation occurred in six patients (0.45 %). All these patients had complete en bloc resection without intraoperative perforation during ESD. Five of six perforations were located in the upper third of the stomach, while one lesion was found in the middle third. Symptoms of peritoneal irritation with rebound tenderness presented within 24 h after ESD in all cases. One patient did not require surgery because the symptoms were localized, and recovered with conservative antibiotic therapy by nasogastric tube placement. The remaining five patients required emergency surgery. There was no mortality in this case series.