Non-exposure Simple Suturing Endoscopic Full-thickness Resection with Sentinel Basin Dissection in Patients with Early Gastric Cancer: the SENORITA 3 Pilot Study
- Author:
Bang Wool EOM
1
;
Chan Gyoo KIM
;
Myeong-Cherl KOOK
;
Hong Man YOON
;
Keun Won RYU
;
Young-Woo KIM
;
Ji Yoon RHO
;
Young-Il KIM
;
Jong Yeul LEE
;
Il Ju CHOI
Author Information
- Publication Type:Original Article
- From:Journal of Gastric Cancer 2020;20(3):245-255
- CountryRepublic of Korea
- Language:English
-
Abstract:
Purpose:Recently, non-exposure simple suturing endoscopic full-thickness resection (NESSEFTR) was developed to prevent tumor exposure to the peritoneal cavity. This study aimed to evaluate the feasibility of NESS-EFTR with sentinel basin dissection for early gastric cancer (EGC).
Materials and Methods:This was the prospective SENORITA 3 pilot. From July 2017 to January 2018, 20 patients with EGC smaller than 3 cm without an absolute indication for endoscopic submucosal dissection were enrolled. The sentinel basin was detected using Tc 99m -phytate and indocyanine green, and the NESS-EFTR procedure was performed when all sentinel basin nodes were tumor-free on frozen pathologic examination. We evaluated the complete resection and intraoperative perforation rates as well as the incidence of postoperative complications.
Results:Among the 20 enrolled patients, one dropped out due to large tumor size, while another underwent conventional laparoscopic gastrectomy due to metastatic sentinel lymph nodes. All NESS-EFTR procedures were performed in 17 of the 18 other patients (94.4%) without conversion, and the complete resection rate was 83.3% (15/18). The intraoperative perforation rate was 27.8% (5/18), and endoscopic clipping or laparoscopic suturing or stapling was performed at the perforation site. There was one case of postoperative complications treated with endoscopic clipping; the others were discharged without any event.
Conclusions:NESS-EFTR with sentinel basin dissection is a technically challenging procedure that obtains safe margins, prevents intraoperative perforation, and may be a treatment option for EGC after additional experience.
