Potentials of Minimally Invasive Technologies in Treatment for Early Gastric Cancer

INTRODUCTION: Gastric cancer remains one of the leading causes of oncological morbidity and mortality.

AIM: To determine the effectiveness and safety of wedge resections of stomach in patients with early gastric cancer (EGC) in comparison with endoscopic intraluminal treatment methods.

MATERIALS AND METHODS: Assessment of the immediate and long-term (5 years) prognosis of 164 patients with EGC who underwent wedge resection of stomach and endoscopic intraluminal interventions was performed. One hundred twenty eight patients were operated on in the volume of endoscopic intraluminal mucosal resection or submucosal dissection (the mean age 68.5 ± 9.2 years; men 53.7%). In 36 patients (the mean age 65.3 ± 7.8 years; men 66.7%), according to gastroscopy in combination with chromogastroscopy, narrow-band magnification endoscopy, the tumor dimensions exceeded those recommended for endoscopic methods. Due to contraindications for classic resection interventions in such patients, wedge resections of the stomach were performed.

RESULTS: In the comparison groups there was no postoperative mortality, however, in the group with use of endoscopic methods, complications were noted (perforations of the stomach and bleeding). All the complications were eliminated endoscopically. In the group of wedge resections, there were no postoperative complications, but in the long-term result, the five-year survival rate was lower than in the group of endoscopic treatment (75.0% versus 92.2%; χ2 = 8.10, p = 0.004) due to a more severe comorbid pathology in the patients of wedge resection group.

CONCLUSION: Safety and equal effectiveness of wedge gastric resections was established in the long-term oncological result in patients with EGC in comparison with intraluminal endoscopic methods.