Fang M, Jiang JH, Zhu DD, Yu FX. Endoscopic submucosal dissection for early gastric cancer and precancerous lesions enhances postoperative recovery and mitigates complication risks. World J Gastrointest Surg 2025; 17(10): 108859 [PMID: 41178886 DOI: 10.4240/wjgs.v17.i10.108859]
Corresponding Author of This Article
Min Fang, Endoscopy Center, The First People's Hospital of Fuyang District, No. 937 Beihuan Road, Fuchun Sub-district, Fuyang District, Hangzhou 311400, Zhejiang Province, China. fangmin4540@126.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Oct 27, 2025; 17(10): 108859 Published online Oct 27, 2025. doi: 10.4240/wjgs.v17.i10.108859
Endoscopic submucosal dissection for early gastric cancer and precancerous lesions enhances postoperative recovery and mitigates complication risks
Fei-Xia Yu, Dan-Dan Zhu, Jian-Hua Jiang, Min Fang
Min Fang, Jian-Hua Jiang, Dan-Dan Zhu, Fei-Xia Yu, Endoscopy Center, The First People's Hospital of Fuyang District, Hangzhou 311400, Zhejiang Province, China
Author contributions: Fang M designed the research and wrote the first manuscript; Fang M, Jiang JH, Zhu DD and Yu FX contributed to conceiving the research and analyzing data; Fang M conducted the analysis and provided guidance for the research; all authors reviewed and approved the final manuscript.
Institutional review board statement: This study was approved by the Ethic Committee of The First People's Hospital of Fuyang District.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: There is no conflict of interest.
Data sharing statement: No additional data are available.
Corresponding author: Min Fang, Endoscopy Center, The First People's Hospital of Fuyang District, No. 937 Beihuan Road, Fuchun Sub-district, Fuyang District, Hangzhou 311400, Zhejiang Province, China. fangmin4540@126.com
Received: June 17, 2025 Revised: July 31, 2025 Accepted: August 27, 2025 Published online: October 27, 2025 Processing time: 128 Days and 23.3 Hours
Abstract
BACKGROUND
Early gastric cancer (EGC) or precancerous lesions (PCLs) are generally small tumors and carry a diminished chance of nodal infiltration. Thus far, very few studies have examined how endoscopic submucosal dissection (ESD) affects postoperative recovery and complications in such patients.
AIM
To evaluate the influence of ESD on postoperative recovery and complications in patients with EGC or PCL.
METHODS
The study population included patients with EGC and PCL admitted to The First People’s Hospital of Fuyang District between December 2022 and December 2024, who were divided into the research (n = 65) and control (n = 55) groups if they underwent ESD and laparoscopic radical gastrectomy, respectively. Therapeutic outcomes (en bloc and curative resection rates), surgical parameters (incision length, intraoperative bleeding, and operative duration), postoperative recovery indices (time to first ambulation/flatus/first oral intake, and hospital stay duration), complications (infection, outflow obstruction, bleeding, and perforation), and tumor markers [carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) 125/19-9] were comparatively evaluated.
RESULTS
Compared with the control group, the research group achieved a significantly higher en bloc resection rate but a notably lower curative resection rate. Additionally, the research group demonstrated shorter incision lengths, reduced intraoperative bleeding, and shorter operative duration. Regarding postoperative recovery, the research group demonstrated earlier ambulation, faster bowel function restoration, quicker oral intake resumption, and shorter hospital stays. Furthermore, an evidently lower overall complication rate was recorded in the research group, as well as markedly reduced postoperative CEA, CA125, and CA19-9 concentrations.
CONCLUSION
When performed for EGC and PCLs, ESD demonstrates advantages such as higher en bloc resection (although lower curative resection rates), surgical trauma minimization, shortened operative duration, and faster recovery. Moreover, it is effective in reducing serum tumor marker levels while maintaining favorable safety.
Core Tip: This study examined how endoscopic submucosal dissection (ESD) influences postoperative recovery and complications in early gastric cancer (EGC) or precancerous lesions (PCLs). Compared with laparoscopic radical gastrectomy, performing ESD for treating EGC and PCLs led to superior en bloc resection, shortened surgical incision length, intraoperative bleeding reduction, and shorter operative duration. Moreover, it effectively accelerated postoperative recovery, lowered complications, and improved serum tumor marker expression.
