ESD - gastric cancer treatment new revolution!

The stripping of endoscopic mucosal (ESD) in recent years there is a new treatment. In minimally invasive techniques, through the ESD to be complete with large lesions, but also "Saojing" part of the mucosal lesions, tumors to achieve radical results.
Early gastric cancer (EGC) is gastric cancer lesions in the mucous membrane or submucosa, regardless of whether there is a lesion size and metastasis. Caesarean section surgery for gastric cancer and lymph node dissection for the treatment is an effective means of EGC, the 5-year survival rate of 96 percent or more. In recent years carried out under the EGC endoscopic mucosal stripping of (ESD) not only treatment and surgical laparotomy similar, but it also enabled the majority of patients from the traditional surgical treatment and the risk of postoperative quality of life seriously affected.
Radical surgery for gastric cancer and lymph node dissection of the past have been considered to be the preferred treatment of EGC, but the surgical complication rate, high mortality, but also seriously affect the quality of life of patients. Research has confirmed that the low rate of metastasis in the EGC suitable for endoscopic therapy.
ESD obvious advantages
ESD expanded the EGC endoscopic removal of the indications, and laparotomy and past EMR, such as endoscopic treatment comparison, ESD has the obvious advantages:
1, individual treatment, well-targeted. ESD can be treated in accordance with the EGC location, size, shape and type of organization developed a reasonable individualized treatment plan, it can guarantee the complete removal of tumor, while maximizing retention and its normal function.
2, minor trauma patients with easy tolerance.
3, the same patients with multiple ESD acceptable treatment, can also be a multi-site treatment.
4, in the case of non-operation through the ESD a complete pathological specimens, to provide accurate tumor histological period, the tumor clear the depth of invasion, differentiation, and clearly the existence of lymphatic and vascular invasion, predicted the existence of metastasis, and other high-risk Factors.
5, compared with the EMR, ESD can be larger area, irregular shape or merger of ulcers, scarring of the tumor from the inherent integrity of a one-time muscle stripping down the surface, complete with a one-time rate of more than 96 percent, significantly reduced tumor Residues and recurrence.
EGC indications
Japan used ESD to expand the indications for the treatment of EGC:
1, tumor diameter ≤ 20 mm, combined with existing ulcer undifferentiated carcinoma mucosa;
2, regardless of size lesions, ulcers exist without the merger of the mucous membrane of differentiated cancer;
3, tumor diameter ≤ 30 mm, the merger of the existence of ulcers in the mucous membrane of differentiated cancer;
4, tumor diameter ≤ 30 mm, combined with existing ulcer differentiated SM1 submucosal cancer.
The frail elderly, a surgical contraindications or suspected metastasis of cancer submucosal refused surgery can be considered as relative indications of sources: 39 community health network