Gastroenterology and Hepatology

Biography

Biography: Romualdas Maskelis

Abstract

Today, there is a growing tendency for second or even Primary Early Gastric Cancer (PEGC) after Endoscopic Submucosal Disorder (ESD) or Mucosal Resection (EMR). The PEGC is earlier, until there is no visible or unnoticed violation in the clinical period, but as it really was, there is no possibility or at least it would be difficult to retrospectively evaluate it. It is clear that today's endoscopic diagnostic of PEGC has improved significantly, and today we can already see cancer when it is in the mucous membrane or in the submucosal layer, only long term and indefinitely endoscopic observation is required. Several retrospective studies have shown excellent long-term results in patients with PEGC, who had endoscopic intervention on stomach cancer. It is reported in the literature that the incidence of PEGC after ESD/EMR is higher than in patients undergoing gastrectomy. Longer life expectancy and PEGC-it is the risk factors independent of one another. Most of the lesions were found at an early half-yearly or annual follow-up and were successfully treated endoscopically, with excellent long-term results. The H. pylori eradication particularly reduces the risk of PEGC. Prolonged life expectancy and polymorphic (metachromic) PEGC are independent of each other, and most of the lesions were found at an early half-yearly or annual follow-up and were successfully treated endoscopically with excellent long-term results, and eradication of H. pylori particularly reduces the risk of PASV. Today, we have an agreement based on previous observations-if stomach cancer becomes occurred within one year after ESD is considered to be missed syndrome of stomach cancer. Four patients with PEGC who were treated endoscopically in Lithuanian NCI since 2016- for two was perform ESD and two were undergo to surgery. Unequivocally, endoscopic operations are now well advanced and doctors performing ESD/EMR are certified (expert status) and institutions are ranked by the number of such interventions per year. In the West, where both morbidity and mortality are higher than in Japan, where early mucosal cancer with high dysplasia is recognized as a cancer. Now any from us thinking about implementing a gastric cancer screening program, as was made in S. Korea where more 40 % patients were treated endoscopically. Today, we already have a risk assessment strategy for PASVs, but are needed for endoscopic monitoring regimes and in the near future the national gastric cancer screening program.