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• W2060744089 abstract "It is difficult to perform complete resection of prepyloric tumors, especially those involving the pyloric channel due to incomplete visualization and insufficient resection margin with forward endoscopic view. This study aimed to investigate outcomes of endoscopic submucosal dissection (ESD) for prepyloric tumors involving pyloric channels to assess the effectiveness of the retroflexion view technique in comparison with forward view technique. Between January 2006 and January 2010, 47 prepyloric tumors were treated by ESD at Severance and Kangnam Severance Hospitals, Seoul, Korea. We retrospectively investigated clinicopathological features and compared treatment results (en bloc resection rate, curative resection rate, complete resection rate, and complications) of conventional forward view technique with those of retroflexion view technique. Of the 47 prepyloric tumors, 23 lesions had pyloric channel involvement (group 1) and 24 lesions did not (group 2). The en bloc resection, curative resection (en bloc resection or piecemeal resection in the completely reconstructed specimen with tumor-free basal and lateral margins) and complete resection (en bloc resection with a tumor-free margin) rates for all ESD cases were 80.9, 85.1 and 70.2%, respectively. The en bloc resection, curative resection and complete resection rates were significantly lower in group 1 than group 2. Of the tumors involving the pyloric channel except 3 cases which were extened to duodenum, 12 lesions were resected with the retroflexion technique and 8 lesions with the conventional forward technique. The curative resection rate was significantly higher in the retroflexion group than the conventional forward group (91.7% vs. 37.5%, respectively; p=0.018). The complete resection rate was also higher in the retroflexion group than the forward group; however, this difference was not statistically significant. There were no significant differences in the en bloc resection rate, procedure time or invasion depth after ESD between the two groups. Bleeding during resection was common, but was managed with hemostatic forceps and hemoclips in all cases. None of the patients experienced perforation or pyloric stenosis after ESD in the retroflexion group and the forward group. ESD using a retroflexion maneuver is a more feasible and effective method for the curative resection of gastric tumors involving the pyloric channel." @default.
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• W2060744089 date "2011-04-01" @default.
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• W2060744089 title "Sa1666 How to Manage Prepyloric Tumors Involving the Pyloric Channel That Are Technically Difficult to Resect Completely With Endoscopic Submucosal Dissection: Comparison of the Retroflexion Versus Conventional Forward View Technique" @default.
• W2060744089 doi "https://doi.org/10.1016/j.gie.2011.03.401" @default.
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