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A n n u a l E u r o p e a n C o n f e r e n c e o n
Gastroenterology
Euro Gastro 2018
J u n e 1 9 - 2 0 , 2 0 1 8
P a r i s , F r a n c e
Page 26
Journal of Clinical Gastroenterology and Hepatology
ISSN 2575-7733
F
or the first time the concept of "early cancer" in Russia (in St. Petersburg)
was brought from Japan in 2005. The number of completed endoscopic
mucosal resection (EMR) from 2005 to 2010 amounted to about 130
procedures. At first, we were very cautious about the selection of patients. For
EMR, we selected patients with adenoma, with high grade neoplasia and within
the mucosal adenocarcinoma. 90 EMR procedures were performed in the large
intestine, 35 of them were EPMR (piecemeal resection) in neoplasms larger
than 2 cm in diameter. The number of relapses was 25%. All these patients
were re-performed EMR. The number of complications at 90 EMR in the colon
was 2 deferred perforations that required surgical treatment and one delayed
bleeding that occurred on the 7
th
day after EMR. In the stomach, we performed
40 EMR; the indications were the same and also the neuro-endocrine tumors.
There were only 2 complications of this perforation of the stomach wall
against the background of atrophic changes, these patients were operated
on. The size of the formations did not exceed 2 cm. Relapse was observed
in only one case, but we managed independently by re-EMR. Simultaneously
with the accumulation of experience and improvement of manual skills in
2008, the technique of endoscopic sub mucosal dissection (ESD) begins to
develop. By 2013, we performed 51 ESDs, 48 in the stomach and three in the
colon. For comparison, in 2008 there were only 3 ESDs per year and in 2013
about 20. Indications for ESD were adenocarcinoma with Sm1a invasion, low-
grade adenocarcinomas within the mucous to 2 cm in diameter. At the same
time there were only three relapses due to careful selection of patients, the
development of manual skills through the creation of training to achieve the
number of performed ESD and this to fairly good results of treatment.
Biography
V Malkov has graduated from the St. Petersburg Pediatric
Medical Academy in 2006. In 2007, he completed the internship
for general surgery at the First Pavlov Medical University
and received primary training in Endoscopy. He worked as
an Endoscopist Surgeon in the Leningrad Regional Hospital
from 2007 to 2013. Since 2013, he served as the Head of
the Department of Endoscopy in the clinic of high medical
technologies named after NI Pirogov. He is an Assistant of the
Department of Endoscopy of the North Western State Medical
Mechnikov University. He is a permanent expert of the training
center of the company Endo Stars (training on biomodels for
endoscopists). He has nine publications in Russian Medical
journals.
wladimir.malkow@gmail.comEndoscopic submucosal dissection as a treatment for early cancer.
Our experience
V Malkov
1
, L Myaukina
2
and A Philin
2
1
Saint Petersburg University Clinic of High Medical Technologies, Russia
2
Leningrad Region Hospital, Russia
V Malkov et al., J Clin Gastroenterol Hepatol 2018, Volume: 2
DOI: 10.21767/2575-7733-C1-002