Endoscopic submucosal dissection combined with endoscopic injection sclerotherapy for early gastric cancer on gastric fundal varices

Kaname Uno, Katsunori Iijima, Tomoyuki Koike, Yasuhiko Abe, Naoki Asano, Satoshi Yokosawa, Akira Imatani, Toru Shimosegawa

Research output: Contribution to journalArticle

Abstract

Currently, there is little report of treatment strategy for early gastric cancer (EGC) on gastric fundal varices (GFVs), because controlling GFVs was more challenging than controlling gastric cardiac varices associated with esophageal varices. We first report effective endoscopic treatment of EGC on GFVs of a 77-year-old man with Child-B cirrhosis. Endoscopic ultrasound and multidetector-row computed tomography studies revealed intramucosal EGC on variceal components, supplied from posterior gastric vein and drained to subphrenic vein without gastrorenal shunt. With informed consent, we performed endoscopic submucosal dissection (ESD) after eradication of GFVs by endoscopic injection sclerotherapy (EIS). Histologic assessment revealed curability of ESD and inflammation and fibrosis around EIS site. Thereafter, no recurrence and complication had occurred. To avoid life-threatening bleeding from GFVs, we achieved complete resection by ESD under direct visualization of submucosa after eradication of GFVs by EIS based on the examination of hemodynamics and local relationship between EGC and GFVs.

Original languageEnglish
JournalSurgical Laparoscopy, Endoscopy and Percutaneous Techniques
Volume22
Issue number4
DOIs
Publication statusPublished - 2012 Aug 1

Keywords

  • EIS
  • ESD
  • early gastric cancer
  • gastric fundal varices

ASJC Scopus subject areas

  • Surgery

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