Underestimation of endoscopic size in large gastric epithelial neoplasms

Jae Sun Song; Byung Sun Kim; Min A Yang; Young Jae Lee; Gum Mo Jung; Ji Woong Kim; Jin Woong Cho

doi:10.5946/ce.2021.269

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자료유형: 학술저널

저자정보: Jae Sun Song (Division of Gastroenterology Department of Internal Medicine Presbyterian Medical Center Jeonju Kor) Byung Sun Kim (Division of Gastroenterology Department of Internal Medicine Presbyterian Medical Center Jeonju Kor) Min A Yang (Division of Gastroenterology Department of Internal Medicine Presbyterian Medical Center Jeonju Kor) Young Jae Lee (Division of Gastroenterology Department of Internal Medicine Presbyterian Medical Center Jeonju Kor) Gum Mo Jung (Division of Gastroenterology Department of Internal Medicine Presbyterian Medical Center Jeonju Kor) Ji Woong Kim (Division of Gastroenterology Department of Internal Medicine Presbyterian Medical Center Jeonju Kor) Jin Woong Cho (Division of Gastroenterology Department of Internal Medicine Presbyterian Medical Center Jeonju Kor)

저널정보: 대한소화기내시경학회 Clinical Endoscopy Clinical Endoscopy 제55권 제6호

발행연도: 2022.11

수록면: 760 - 766 (7page)

DOI: 10.5946/ce.2021.269

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Background/Aims: Endoscopic submucosal dissection (ESD) is an effective method for resecting gastric adenomas and adenocarcino-mas. A significant discrepancy was observed between endoscopic and pathological sizes in samples obtained from patients undergoingESD. This study elucidates the factors affecting size discrepancy after formalin fixation. Methods: The records of 64 patients with 69 lesions were analyzed, including 50 adenomas and 19 adenocarcinomas. Data on location,gross shape, histology, and size after fixation in formalin were collected. Results: The mean size of the resected specimen appeared to decrease after formalin fixation (37.5 mm prefixation vs. 35.8 mm post-fixation, p<0.05). The mean long axis diameter of the lesions was 20.3±7.9 mm prefixation and 13.4±7.9 mm postfixation. Size differ-ences in lesions smaller than 20 mm were significantly greater than those in lesions larger than 20 mm (7.6±5.6 mm vs. 2.5±5.8 mm,p<0.01). In multivariate analysis, a tumor size of ≥20 mm was found to be an independent factor affecting size postformalin fixation(p<0.05). Conclusions: The endoscopic size of lesions before ESD may be underestimated in tumors larger than 20 mm in size. Therefore, in-creased attention must be paid during ESD to avoid instances of incomplete resection.

#Endoscopic submucosal dissection #Endoscopy #Stomach neoplasms

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