P-073 - The clinical usefulness of pronase bowel preparation before ESD for gastric neoplasm

Date 04 July 2015
Event WorldGI 2015
Session Posters
Topics Gastric Cancer
Surgery and/or Radiotherapy of Cancer
Presenter S. Kim
Citation Annals of Oncology (2015) 26 (suppl_4): 1-100. 10.1093/annonc/mdv233
Authors S. Kim1, Y.-. Park2, I.H. Baek3, Y.K. Cho2, Y.J. Jo2
  • 1Eulji Hospital of Eulji University, Seoul/
  • 2Eulji Hospital of Eulji University, Seoul/KR
  • 3Kyung Hee University School of Medicine, Seoul/KR

Abstract

Introduction

Endoscopic submucosal dissection (ESD) is a major treatment option for gastric neoplasia. However, gastric mucus and other substances influence to decline endoscopic visual score, safety of resection margin and complete resection rate. These factors were related with poor prognosis of patients. Pronase is a non-specific protease endoscopic premedication. The primary end point of this study is the relations between the pronase premedication and improvement of procedure result

Methods

From July 2014 to July 2015, 70 patients with flat adenoma or early gastric cancer (EGC) type II will be investigated. The range of lesion size is between 0.5 cm with 5cm. Before ESD, Pronase experiment group and simethicone contrast group are selected through randomization. Each group will provide pronase and simethicone. Endoscopic visual score, lesion marking time, total procedure time, complication, complete resection, lateral safety margin of resected specimen will be recorded. And, difference of each group will be analyzed.

Results

So far, total of 10 ESD cases diagnosed with flat adenoma or early gastric cancer collected. Adenoma was 4 cases (Pronase group: 1, Simethicone group: 3), and EGC was 6 cases (Pronase group: 4, Simethicone group: 2). Mean lesion size of Pronase group is 1.5cm x 1.42cm. Mean lesion size of Simethicone group is 1.92cm x 1.14cm. Mean of endoscopic visual score was 1.2 and 2.4 (lower is better). Mean of total procedure time is 1096 seconds and 2526 seconds respectively. Lateral safe margin is 0.36cm and 0.36cm. Complication occurred 1 case (microperforation at simethicone group).

Conclusion

So far, total of 10 ESD cases diagnosed with flat adenoma or early gastric cancer collected. Adenoma was 4 cases (Pronase group: 1, Simethicone group: 3), and EGC was 6 cases (Pronase group: 4, Simethicone group: 2). Mean lesion size of Pronase group is 1.5cm x 1.42cm. Mean lesion size of Simethicone group is 1.92cm x 1.14cm. Mean of endoscopic visual score was 1.2 and 2.4 (lower is better). Mean of total procedure time is 1096 seconds and 2526 seconds respectively. Lateral safe margin is 0.36cm and 0.36cm. Complication occurred 1 case (microperforation at simethicone group).