Feasibility and safety of endoscopic submucosal dissection of esophageal or gastric carcinomas under general Anesthesia

Abstract

Objective: To investigate the feasibility and safety of endoscopic submucosal dissection (ESD) of esophageal or gastric carcinomas under general anesthesia. Subjects and Methods: ESD removal of esophageal or gastric carcinomas was performed in 59 patients under midazolam sedation (control group), and in 46 patients under general anesthesia (GA group). The procedural times, perioperative complications and patient's satisfaction with the procedures were recorded. Results: There was no statistically significant difference in age (65 ±12 vs. 58 ±11), male gender (43.5 vs. 49.2%), types or location or the size of the carcinomas (30 ± 6 vs. 28 ± 7 mm) between the control and GA groups (p > 0.05). The mean procedural time in the GA group was shorter than in the control group (42.5 ± 5.5 vs. 79.0 ± 13.2 min, p = 0.01). The combined gastric perforation and postprocedural bleeding rate in the GA group was lower than in the control group, but the difference did not reach statistical significance (p = 0.06). In the GA group, all patients rated the procedural experience as satisfactory, while in the control group, 38 (64.5%) rated the experience as satisfactory (p = 0.001). Conclusion: ESD under general anesthesia was associated with a shorter procedure time and a high rate of patient's satisfaction with the procedures. Copyright © 2012 S. Karger AG, Basel.