Change in gastric emptying eight weeks after endoscopic submucosal dissection in patients with early gastric cancer

 

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Background: Gastric emptying after endoscopic submucosal dissection (ESD) for early gastric cancer is not clear. The aim of this study was to evaluate changes in gastric emptying from before ESD to 8 weeks after ESD.

Methods: In total, 54 patients with early gastric cancer were enrolled in this study. A breath test with carbon 13 (¹³C) was conducted before ESD and at 1 and 8 weeks after ESD. The T_lag and T_1/2 values were analyzed at each time point. The primary outcomes were the changes in the T_lag and T_1/2 values from before ESD to 1 and 8 weeks after ESD. The secondary outcomes were the factors associated with the changes in the T_lag and T_1/2 values.

Results: Gastric emptying was delayed at 1 and 8 weeks after ESD compared with before ESD (T_lag P = 0.002, P < 0.001; T_1/2 P = 0.005, P = 0.001, respectively). The changes in the T_lag and T_1/2 values from before ESD to 1 week after ESD were greater for proximal stomach lesions than for distal stomach lesions (P = 0.028, P < 0.001). Proximal stomach lesions were identified as the significant factor that influenced changes in the T_lag and T_1/2 values from before ESD to 1 week after ESD in the multivariate analyses (T_lag P = 0.003, T_1/2 P = 0.005).

Conclusions: ESD induced delayed gastric emptying until 8 weeks after ESD. Proximal stomach lesions were also associated with decreased emptying 1 week after ESD.

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