Updated evidence on endoscopic resection of early gastric cancer from Japan

Background Endoscopic resection for early gastric cancer (EGC) plays a central role in the treatment of EGC in Japan. However, there is still room for improvement, and it is necessary to summarize the recently obtained knowledge from Japan for further improvement. Methods We conducted a PubMed search to select relevant articles in the 5 years until September 18, 2016, using the keywords gastric cancer'' and endoscopic treatment,'' endoscopic submucosal dissection,'' endoscopic mucosal resection,'' or polypectomy'' and filtering article types as clinical study'' or clinical trial.'' Results Among the 329 articles selected automatically from the keywords polypectomy'' (1 article), endoscopic mucosal resection'' (29 articles), endoscopic submucosal dissection'' (77 articles), and endoscopic treatment'' (222 articles) in combination with gastric cancer,'' 32 relevant articles from Japanese investigators were chosen. Seven articles were categorized into equipment,'' 4 into preparation and sedation,'' 17 into complications and their prevention,'' and 4 into therapeutic outcomes.'' Among them, CO2 insufflation, propofol sedation, and how to prevent post-endoscopic submucosal dissection (ESD) ulcer bleeding and achieve post-ESD ulcer healing were intensively investigated. Long-term outcomes of endoscopic mucosal resection and ESD were also reported as favorable outcomes. Conclusions Endoscopic resection for EGC is still developing toward an ideal form, pursuing a more reliable, safer, and faster minimally invasive treatment.