Dongjie Yang, MD; Qinbo Cai, MD, PhD; Qinbo Cai, PhD; Wentong Lan, MN; Wentong Lan; Bingqi Shen, MD; Bingqi Shen, PhD; Yuan Lin, MD, PhD; Yuan Lin, PhD; Lele Zhang, MD; MD; MinXuan Shen, PhD; Huafeng Fu, MD; Jie Zhang, PhD | The First Affiliated Hospital of Sun Yat-sen University
Competition Sponsor: Chinese Academy of Medical Sciences
Award year: 2021
Gastric cancer, with a high incidence in middle-aged and elderly people, is the fifth most common malignant tumor in the world with the fourth highest mortality rate. In China, its morbidity and mortality are both the second highest among malignant tumors. With the extension and improvement of gastric cancer screening, early gastric cancer (EGC) is gradually increasing. Subtotal gastrectomy used in traditional open or laparoscopic surgery is traumatic to the elderly, which seriously affects their health and longevity. In contrast, endoscopic resection of EGC is less invasive. Recently, endoscopic submucosal dissection (ESD) is most commonly used for endoscopic resection of EGC. However, the application of this technique is very narrow, covering only a portion of intramucosal carcinoma with cT1a stage. This project will explore the use of endoscopic full-thickness gastrectomy combined with the newly developed inverting suture technique of our research group to expand the applications of endoscopic treatment for EGC, especially to include EGC with cT1b into the scope of endoscopic treatment. The main technical scheme includes the use of the seromuscular closure clip invented by our research group to close the defect under the condition of the seromuscular layer turning inward to the gastric cavity, with the aid of a twin grasper after full-thickness gastric wall resection. This new technique will expand the indications for endoscopic resection of EGC without lymphnodes metastases, while also ensure application of Laparoscopic Endoscopic Cooperative Surgery (LECS) for EGC with lymphnodes metastases, maximize the protection of gastric function and reduce patient trauma.