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A large study reviewed endoscopic resection (a surgical technique used to remove tissue with the help of an endoscope) for early stage stomach cancer. It found that endoscopic submucosal dissection (ESD) is a useful technique for removing stomach cancer in people who are eligible for the procedure. ESD is an endoscopic procedure that removes the area of the stomach containing cancer and the underlying submucosa. The submucosa is a deeper layer of tissue next to the inner lining (mucosa) of the stomach. Tissue that is removed in one piece, rather than in several pieces, is associated with a lower rate of recurrence. Furthermore, older people and those with cancer in the lower part of the stomach (antrum) had a lower rate of bleeding complications with this procedure. ESD may be used to completely remove stomach cancer that is determined to be early stage by endoscopic ultrasound (Digestion,PMID 19776581; European Journal of Gastroenterology & Hepatology,PMID 19494784; Gastrointestinal Endoscopy,PMID 19249769; Gut,PMID 19001058; Surgical Endoscopy,PMID 18553202).
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