Ricerc@Sapienza

Endoscopic submucosal dissection (ESD) allows removing neoplastic lesions on gastric
mucosa, including early gastric cancer (EGC) and dysplasia. Data on ESD from Western countries
are still scanty. We report results of ESD procedures performed in Italy. Data of consecutive patients
who underwent ESD for gastric neoplastic removal were analyzed. The en bloc resection rate and
the R0 resection rates for all neoplastic lesions were calculated, as well as the curative rate (i.e., no
need for surgical treatment) for EGC. The incidence of complications, the one‐month mortality, and
the recurrence rate at one‐year follow‐up were computed. A total of 296 patients with 299 gastric
lesions (80 EGC) were treated. The en bloc resection was successful for 292 (97.6%) and the R0 was
achieved in 266 (89%) out of all lesions. In the EGC group, the ESD was eventually curative in 72.5%
(58/80) following procedure. A complication occurred in 30 (10.1%) patients. Endoscopic treatment
was successful in all 3 perforations, whereas it failed in 2 out of 27 bleeding patients who were
treated with radiological embolization (1 case) or surgery (1 case). No procedure‐related deaths at
one‐month follow‐up were observed. Lesion recurrence occurred in 16 (6.2%) patients (6 EGC and
10 dysplasia). In conclusion, the rate of both en bloc and R0 gastric lesions removal was very high in
Italy. However, the curative rate for EGC needs to be improved. Complications were acceptably low
and amenable at endoscopy.