Endoscopy 2010; 42(12): 1112-1115
DOI: 10.1055/s-0030-1255932
Case report/series

© Georg Thieme Verlag KG Stuttgart · New York

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

N.  Hanaoka1 , N.  Uedo1 ,  2 , R.  Ishihara1 , K.  Higashino1 , Y.  Takeuchi1 , T.  Inoue1 , R.  Chatani1 , M.  Hanafusa1 , Y.  Tsujii1 , H.  Kanzaki1 , N.  Kawada1 , H.  Iishi1 , M.  Tatsuta1 ,  2 , Y.  Tomita3 , I.  Miyashiro4 , M.  Yano4
  • 1Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
  • 2Endoscopic Training and Learning Center, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
  • 3Department of Pathology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
  • 4Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
Further Information

Publication History

submitted 28 May 2010

accepted after revision 14 July 2010

Publication Date:
30 November 2010 (online)

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.

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N. UedoMD 

Department of Gastrointestinal Oncology
Osaka Medical Center for Cancer and Cardiovascular Diseases

1-3-3 Nakamichi, Higashinari-ku
Osaka 537-8511
Japan

Fax: +81-6-69814067

Email: uedou-no@mc.pref.osaka.jp

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