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1Propofol sedation during endoscopic treatment for early gastric cancer compared to midazolam显示文摘Endoscopic submucosal dissection(ESD)has been proposed as the gold standard in the treatment of early gastric cancer because it facilitates a more accurate histological assessment and reduces the risk of tumor recurrence.However,the time course of ESD for large gastric tumors is frequently prolonged because of the tumor size and technical difficulties and typically requires higher doses of sedative and pain-controlling drugs.Sedative or anesthetic drugs such as midazolam or propofol are used during the procedure.Therapeutic endoscopy of early gastric cancers can often be performed with only moderate sedation.Compared with midazolam,propofol has a very fast onset of action,short plasma half-life and time to achieve sedation,faster time to recovery and discharge,and results in higher patient satisfaction.For overall success,maintaining safety and stability not only during the procedure but also subsequently in the recovery room and ward is necessary.In obese patients,it is recommended that the injected dose be based on a calculated standard weight.Cooperation between gastroenterologists,surgeons,and anesthesiologists is imperative for a successful ESD procedure.Shinsuke Kiriyama Hiroshi Naitoh Hiroyuki Kuwano 2014World Journal of Gastroenterology2014,20,34:14
2Endoscopic therapy for early gastric cancer: Standard techniques and recent advances in ESD显示文摘The technique of endoscopic submucosal dissection(ESD)is now a well-known endoscopic therapy for early gastric cancer.ESD was introduced to resect large specimens of early gastric cancer in a single piece.ESD can provide precision of histologic diagnosis and can also reduce the recurrence rate.However,the drawback of ESD is its technical difficulty,and,consequently,it is associated with a high rate of complications,the need for advanced endoscopic techniques,and a lengthy procedure time.Various advances in the devices and techniques used for ESD have contributed to overcoming these drawbacks.Keiichiro Kume 2014World Journal of Gastroenterology2014,20,21:10
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