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Keywords:

  • 13C-octanoic acid breath test;
  • endoscopic submucosal dissection;
  • gastric emptying

Abstract

Background and Aim

Endoscopic submucosal dissection (ESD) is now accepted as a minimally invasive treatment for early gastric cancer (EGC). To our knowledge, however, the functional effects of ESD have not been determined in patients with EGC. We therefore investigated whether gastric motility was affected by ESD.

Methods

Using the 13C-octanoic acid breath test, gastric emptying of solid test meals was examined in 26 EGC patients and 18 healthy controls, with EGC patients assayed before and about 2 months after ESD. Based on 13CO2 breath-excretion curves, the lag-phase time (Tlag), half-emptying time (T1/2), and gastric emptying coefficient (GEC) were calculated as indices of gastric emptying.

Results

In healthy controls, the mean Tlag, T1/2, and GEC were 85.5 ± 4.9 min, 148.5 ± 8.0 min, and 3.01 ± 0.09 h, respectively. Before ESD, the mean Tlag, T1/2, and GEC in the EGC patients were 90.1 ± 5.5 min, 174.7 ± 10.4 min, 2.64 ± 0.08 h, respectively. GEC, but not Tlag or T1/2, differed significantly in the two groups, with gastric emptying slower in EGC patients than in controls. Relative to before ESD, the mean Tlag, T1/2, and GEC in EGC patients after ESD were 109.2% ± 7.8%, 107.9% ± 9.6%, 108.4% ± 4.7%, respectively, indicating that ESD did not significantly affect any of these gastric emptying parameters in EGC patients.

Conclusion

ESD is an effective treatment for EGC both in preserving organs and gastric motility.