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Gastroenterology Research and Practice
Volume 2018 (2018), Article ID 4378945, 10 pages
Review Article

The Comparison between Endoscopic Submucosal Dissection and Surgery in Gastric Cancer: A Systematic Review and Meta-Analysis

Department of Gastroenterology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi'an, Shaanxi 710061, China

Correspondence should be addressed to Shuixiang He

Received 11 October 2017; Accepted 17 December 2017; Published 18 February 2018

Academic Editor: Riccardo Casadei

Copyright © 2018 Junbi Hu et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Aims. There are two treatment modalities for early gastric cancer (EGC)—surgery and endoscopic submucosal dissection (ESD). We aimed to compare the safety and efficacy of ESD with surgery. Method. The article was performed by searching PubMed databases. Data were extracted using predefined form and odds ratios (OR) with 95% confidence intervals (CI) calculated and value. Results. 13 studies were identified. The incidence of perforation in two groups was different [OR = 6.18 (95% CI: 1.37–27.98), ]. The prevalences of synchronous and metachronous cancer in the ESD group were higher than those in the surgery group [OR = 8.52 (95% CI: 1.99–36.56), P = 0.004 and OR = 7.15 (95% CI: 2.95–17.32), ]. The recurrence and complete resection rates were different [OR = 6.93 (95% CI: 2.83–16.96), and OR = 0.32 (95% CI: 0.20–0.52), ]. Compared with the surgery group, the hospital stay was shorter [IV = −7.15 (95% CI: −9.08–5.22), ], the adverse event rate was lower, and the quality of life (QOL) was better in the ESD group. The difference of bleeding was not found. Conclusion. ESD appears to be preferable for EGC, due to a lower rate of adverse events, shorter hospital stay, cheaper cost, and higher QOL.