KMID : 1038120220550010077
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Clinical Endoscopy 2022 Volume.55 No. 1 p.77 ~ p.85
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Clinical Outcomes and Adverse Events of Gastric Endoscopic Submucosal Dissection of the Mid to Upper Stomach under General Anesthesia and Monitored Anesthetic Care
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Chang Jong-In
Kim Tae-Jun Hwang Na-Young Sohn In-Suk Min Yang-Won Lee Hyuk Min Byung-Hoon Lee Jun-Haeng Rhee Poong-Lyul Kim Jae-J.
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Abstract
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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.
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KEYWORD
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Anesthesia, Early gastric cancer, Endoscopic submucosal dissection
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