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Diagnostics
Volume 15
Issue 3
10.3390/diagnostics15030335
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Article

The Pilot Study on Detecting Perforation with Abdominal Ultrasound During Gastric Endoscopic Submucosal Dissection

by
Ji Eun Kim
1,*,†,
Jeayoun Kim
2,†,
Tae Se Kim
1,
Yang Won Min
1,
Hyuk Lee
1,
Byung-Hoon Min
1,
Jun Haeng Lee
1,
Poong-Lyul Rhee
1 and
Jae J. Kim
1,*
1
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
2
Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
*
Authors to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Diagnostics 2025, 15(3), 335; https://doi.org/10.3390/diagnostics15030335
Submission received: 26 November 2024 / Revised: 25 January 2025 / Accepted: 27 January 2025 / Published: 31 January 2025
(This article belongs to the Section Medical Imaging and Theranostics)
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Abstract

Objectives: The indications for endoscopic submucosal dissection (ESD) for gastric adenoma and gastric cancer have expanded, leading to an increase in the number of patients with high procedural complexity. Post-ESD perforations prolong hospital stays and increase costs. However, no studies have focused on detecting micro-perforations during ESD. This study aimed to identify signs of perforation using abdominal ultrasound during gastric ESD. Materials and methods: This pilot study analyzed 50 patients who underwent abdominal ultrasound (VScan Air™, GE Healthcare) during ESD at Samsung Medical Center (March 2023–July 2024). Perforation was assessed via ultrasound, and post-procedure X-rays were performed for three days to detect free air. Results: Among 50 patients (median age 60, 76.1% male), the median procedure time was 60 min. Lesions were most common in the antrum (30.4%) and lesser curvature (17.4%). Pathology revealed 32.6% well-differentiated and 10.9% moderately differentiated adenomas, with 15.2% showing high-grade dysplasia. Free air was detected in three patients after procedures involving the body wall of the stomach. Abdominal US showed indirect signs of perforation, including an abnormal peritoneal line, hyperechoic shadowing, and an absence of normal gas patterns, confirmed by X-ray. Conclusions: Abdominal US is a simple, useful tool for rapid detection of perforation during ESD, enabling timely intervention. Further multicenter studies are needed to confirm these findings.
Keywords: endoscopic submucosal dissection (ESD); abdomen ultrasound; gastric adenoma; early gastric cancer (EGC); perforation endoscopic submucosal dissection (ESD); abdomen ultrasound; gastric adenoma; early gastric cancer (EGC); perforation

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MDPI and ACS Style

Kim, J.E.; Kim, J.; Kim, T.S.; Min, Y.W.; Lee, H.; Min, B.-H.; Lee, J.H.; Rhee, P.-L.; Kim, J.J. The Pilot Study on Detecting Perforation with Abdominal Ultrasound During Gastric Endoscopic Submucosal Dissection. Diagnostics 2025, 15, 335. https://doi.org/10.3390/diagnostics15030335

AMA Style

Kim JE, Kim J, Kim TS, Min YW, Lee H, Min B-H, Lee JH, Rhee P-L, Kim JJ. The Pilot Study on Detecting Perforation with Abdominal Ultrasound During Gastric Endoscopic Submucosal Dissection. Diagnostics. 2025; 15(3):335. https://doi.org/10.3390/diagnostics15030335

Chicago/Turabian Style

Kim, Ji Eun, Jeayoun Kim, Tae Se Kim, Yang Won Min, Hyuk Lee, Byung-Hoon Min, Jun Haeng Lee, Poong-Lyul Rhee, and Jae J. Kim. 2025. "The Pilot Study on Detecting Perforation with Abdominal Ultrasound During Gastric Endoscopic Submucosal Dissection" Diagnostics 15, no. 3: 335. https://doi.org/10.3390/diagnostics15030335

APA Style

Kim, J. E., Kim, J., Kim, T. S., Min, Y. W., Lee, H., Min, B.-H., Lee, J. H., Rhee, P.-L., & Kim, J. J. (2025). The Pilot Study on Detecting Perforation with Abdominal Ultrasound During Gastric Endoscopic Submucosal Dissection. Diagnostics, 15(3), 335. https://doi.org/10.3390/diagnostics15030335

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