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Practice of Endoscopic Mucosal Resection A Survey to Endoscopic Units in Europe
Class 15 ndash FMUP ndash 2008200919th December 2008
Andreacute Carvalho Ana Morais Clara Ferreira Francisco Mouratildeo Joatildeo Santos Joseacute Martins Mariana Formigo Manuel Cruz Raquel Santos
Maacuterio Dinis-Ribeiro Ricardo Santos
BACKGROUND
Gastric Cancer
-Steady decline on the incidence 1
vs
- High rates of death by recurrence and progression of the disease 1
1 Roukos DH Current advances and changes in treatment strategy may improve survival and quality of life in patients with potentially curable gastric cancer Academic Department of Surgery Medical School University of Ioannina Greece Ann Surg Oncol 1999 Jan-Feb6(1)46-56
Spread on the scientific interest
BACKGROUND
Detection
Stage of development
Early stage Advanced stage
Different approaches on the treatment
BACKGROUNDbull EMR and ESD ndash an answer
Japan 1980 described in 1984
bull Early gastric cancer (mucosasubmucosa)
bull Alternative to surgery
BACKGROUND
Advantages2bullLess morbiditybullLess mortalitybullLess invasivebullPosterior histological analysisbullAllows posterior surgery
Better quality of
life
2 Ahmadi A Draganov Endoscopic mucosal resection in the upper gastrointestinal tract P Division Gastroenterology Hepatology and Nutrition University of Florida Gainesville Florida 32610 United States World J Gastroenterol 2008 Apr 714(13)1984-9
Disadvantages3bull High incidence of complicationsbullRequires high endoscopy skills
3 Tanaka M Ono H Hasuike N Endoscopic submucosal dissection of early gastric cancer Takizawa KDivision of Endoscopy and Gastrointestinal Oncology Shizuoka Cancer Center Hospital Shizuoka Japan
JUSTIFICATION
bull In Europe bulllt10 of all endoscopically diagnosed gastric cancers are in an earlier stage of development 4
bull In Japan bull50 of all endoscopically diagnosed gastric cancers are in an earlier stage of development 4
4 Roukos DH Current advances and changes in treatment strategy may improve survival and quality of life in patients with potentially curable gastric cancer Academic Department of Surgery Medical School University of Ioannina Greece Ann Surg Oncol 1999 Jan-Feb6(1)46-56
RESEARCH QUESTION
What is the current use of endoscopic resection techniques (EMRESD) in european centers
STUDY DESIGN- Observational study- cross-sectional study
-
PARTICIPANTS
Target populationEuropean endoscopic unitscenters
Sampling methodNon-random
Members of the national societies of endoscopy
European centers that published papers indexed in Pubmed during 2007 and 2008 in
Gastrointestinal Endoscopy journal Endoscopy journal
DATA COLLECTION AND VARIABLES
bull Online questionnaires regarding the following variablesbull Number and tipe of proceduresbull Completeness of procedurebull Complicationsbull Type of lesionsbull Number and expertise of operators
bull Questionnaire will be completed and used by the participants using Medquest developed on SBIM-FMUP
GANTT CHART
GANTT CHART
GANTT CHART
Expected results
bull Final product paper with the results of the study
- Earlier perspectives
- Small rates of usage- Non application due to the inexistence of enough
knowledge of the techniques
BACKGROUND
Gastric Cancer
-Steady decline on the incidence 1
vs
- High rates of death by recurrence and progression of the disease 1
1 Roukos DH Current advances and changes in treatment strategy may improve survival and quality of life in patients with potentially curable gastric cancer Academic Department of Surgery Medical School University of Ioannina Greece Ann Surg Oncol 1999 Jan-Feb6(1)46-56
Spread on the scientific interest
BACKGROUND
Detection
Stage of development
Early stage Advanced stage
Different approaches on the treatment
BACKGROUNDbull EMR and ESD ndash an answer
Japan 1980 described in 1984
bull Early gastric cancer (mucosasubmucosa)
bull Alternative to surgery
BACKGROUND
Advantages2bullLess morbiditybullLess mortalitybullLess invasivebullPosterior histological analysisbullAllows posterior surgery
Better quality of
life
2 Ahmadi A Draganov Endoscopic mucosal resection in the upper gastrointestinal tract P Division Gastroenterology Hepatology and Nutrition University of Florida Gainesville Florida 32610 United States World J Gastroenterol 2008 Apr 714(13)1984-9
Disadvantages3bull High incidence of complicationsbullRequires high endoscopy skills
3 Tanaka M Ono H Hasuike N Endoscopic submucosal dissection of early gastric cancer Takizawa KDivision of Endoscopy and Gastrointestinal Oncology Shizuoka Cancer Center Hospital Shizuoka Japan
JUSTIFICATION
bull In Europe bulllt10 of all endoscopically diagnosed gastric cancers are in an earlier stage of development 4
bull In Japan bull50 of all endoscopically diagnosed gastric cancers are in an earlier stage of development 4
4 Roukos DH Current advances and changes in treatment strategy may improve survival and quality of life in patients with potentially curable gastric cancer Academic Department of Surgery Medical School University of Ioannina Greece Ann Surg Oncol 1999 Jan-Feb6(1)46-56
RESEARCH QUESTION
What is the current use of endoscopic resection techniques (EMRESD) in european centers
STUDY DESIGN- Observational study- cross-sectional study
-
PARTICIPANTS
Target populationEuropean endoscopic unitscenters
Sampling methodNon-random
Members of the national societies of endoscopy
European centers that published papers indexed in Pubmed during 2007 and 2008 in
Gastrointestinal Endoscopy journal Endoscopy journal
DATA COLLECTION AND VARIABLES
bull Online questionnaires regarding the following variablesbull Number and tipe of proceduresbull Completeness of procedurebull Complicationsbull Type of lesionsbull Number and expertise of operators
bull Questionnaire will be completed and used by the participants using Medquest developed on SBIM-FMUP
GANTT CHART
GANTT CHART
GANTT CHART
Expected results
bull Final product paper with the results of the study
- Earlier perspectives
- Small rates of usage- Non application due to the inexistence of enough
knowledge of the techniques
BACKGROUND
Detection
Stage of development
Early stage Advanced stage
Different approaches on the treatment
BACKGROUNDbull EMR and ESD ndash an answer
Japan 1980 described in 1984
bull Early gastric cancer (mucosasubmucosa)
bull Alternative to surgery
BACKGROUND
Advantages2bullLess morbiditybullLess mortalitybullLess invasivebullPosterior histological analysisbullAllows posterior surgery
Better quality of
life
2 Ahmadi A Draganov Endoscopic mucosal resection in the upper gastrointestinal tract P Division Gastroenterology Hepatology and Nutrition University of Florida Gainesville Florida 32610 United States World J Gastroenterol 2008 Apr 714(13)1984-9
Disadvantages3bull High incidence of complicationsbullRequires high endoscopy skills
3 Tanaka M Ono H Hasuike N Endoscopic submucosal dissection of early gastric cancer Takizawa KDivision of Endoscopy and Gastrointestinal Oncology Shizuoka Cancer Center Hospital Shizuoka Japan
JUSTIFICATION
bull In Europe bulllt10 of all endoscopically diagnosed gastric cancers are in an earlier stage of development 4
bull In Japan bull50 of all endoscopically diagnosed gastric cancers are in an earlier stage of development 4
4 Roukos DH Current advances and changes in treatment strategy may improve survival and quality of life in patients with potentially curable gastric cancer Academic Department of Surgery Medical School University of Ioannina Greece Ann Surg Oncol 1999 Jan-Feb6(1)46-56
RESEARCH QUESTION
What is the current use of endoscopic resection techniques (EMRESD) in european centers
STUDY DESIGN- Observational study- cross-sectional study
-
PARTICIPANTS
Target populationEuropean endoscopic unitscenters
Sampling methodNon-random
Members of the national societies of endoscopy
European centers that published papers indexed in Pubmed during 2007 and 2008 in
Gastrointestinal Endoscopy journal Endoscopy journal
DATA COLLECTION AND VARIABLES
bull Online questionnaires regarding the following variablesbull Number and tipe of proceduresbull Completeness of procedurebull Complicationsbull Type of lesionsbull Number and expertise of operators
bull Questionnaire will be completed and used by the participants using Medquest developed on SBIM-FMUP
GANTT CHART
GANTT CHART
GANTT CHART
Expected results
bull Final product paper with the results of the study
- Earlier perspectives
- Small rates of usage- Non application due to the inexistence of enough
knowledge of the techniques
BACKGROUNDbull EMR and ESD ndash an answer
Japan 1980 described in 1984
bull Early gastric cancer (mucosasubmucosa)
bull Alternative to surgery
BACKGROUND
Advantages2bullLess morbiditybullLess mortalitybullLess invasivebullPosterior histological analysisbullAllows posterior surgery
Better quality of
life
2 Ahmadi A Draganov Endoscopic mucosal resection in the upper gastrointestinal tract P Division Gastroenterology Hepatology and Nutrition University of Florida Gainesville Florida 32610 United States World J Gastroenterol 2008 Apr 714(13)1984-9
Disadvantages3bull High incidence of complicationsbullRequires high endoscopy skills
3 Tanaka M Ono H Hasuike N Endoscopic submucosal dissection of early gastric cancer Takizawa KDivision of Endoscopy and Gastrointestinal Oncology Shizuoka Cancer Center Hospital Shizuoka Japan
JUSTIFICATION
bull In Europe bulllt10 of all endoscopically diagnosed gastric cancers are in an earlier stage of development 4
bull In Japan bull50 of all endoscopically diagnosed gastric cancers are in an earlier stage of development 4
4 Roukos DH Current advances and changes in treatment strategy may improve survival and quality of life in patients with potentially curable gastric cancer Academic Department of Surgery Medical School University of Ioannina Greece Ann Surg Oncol 1999 Jan-Feb6(1)46-56
RESEARCH QUESTION
What is the current use of endoscopic resection techniques (EMRESD) in european centers
STUDY DESIGN- Observational study- cross-sectional study
-
PARTICIPANTS
Target populationEuropean endoscopic unitscenters
Sampling methodNon-random
Members of the national societies of endoscopy
European centers that published papers indexed in Pubmed during 2007 and 2008 in
Gastrointestinal Endoscopy journal Endoscopy journal
DATA COLLECTION AND VARIABLES
bull Online questionnaires regarding the following variablesbull Number and tipe of proceduresbull Completeness of procedurebull Complicationsbull Type of lesionsbull Number and expertise of operators
bull Questionnaire will be completed and used by the participants using Medquest developed on SBIM-FMUP
GANTT CHART
GANTT CHART
GANTT CHART
Expected results
bull Final product paper with the results of the study
- Earlier perspectives
- Small rates of usage- Non application due to the inexistence of enough
knowledge of the techniques
BACKGROUND
Advantages2bullLess morbiditybullLess mortalitybullLess invasivebullPosterior histological analysisbullAllows posterior surgery
Better quality of
life
2 Ahmadi A Draganov Endoscopic mucosal resection in the upper gastrointestinal tract P Division Gastroenterology Hepatology and Nutrition University of Florida Gainesville Florida 32610 United States World J Gastroenterol 2008 Apr 714(13)1984-9
Disadvantages3bull High incidence of complicationsbullRequires high endoscopy skills
3 Tanaka M Ono H Hasuike N Endoscopic submucosal dissection of early gastric cancer Takizawa KDivision of Endoscopy and Gastrointestinal Oncology Shizuoka Cancer Center Hospital Shizuoka Japan
JUSTIFICATION
bull In Europe bulllt10 of all endoscopically diagnosed gastric cancers are in an earlier stage of development 4
bull In Japan bull50 of all endoscopically diagnosed gastric cancers are in an earlier stage of development 4
4 Roukos DH Current advances and changes in treatment strategy may improve survival and quality of life in patients with potentially curable gastric cancer Academic Department of Surgery Medical School University of Ioannina Greece Ann Surg Oncol 1999 Jan-Feb6(1)46-56
RESEARCH QUESTION
What is the current use of endoscopic resection techniques (EMRESD) in european centers
STUDY DESIGN- Observational study- cross-sectional study
-
PARTICIPANTS
Target populationEuropean endoscopic unitscenters
Sampling methodNon-random
Members of the national societies of endoscopy
European centers that published papers indexed in Pubmed during 2007 and 2008 in
Gastrointestinal Endoscopy journal Endoscopy journal
DATA COLLECTION AND VARIABLES
bull Online questionnaires regarding the following variablesbull Number and tipe of proceduresbull Completeness of procedurebull Complicationsbull Type of lesionsbull Number and expertise of operators
bull Questionnaire will be completed and used by the participants using Medquest developed on SBIM-FMUP
GANTT CHART
GANTT CHART
GANTT CHART
Expected results
bull Final product paper with the results of the study
- Earlier perspectives
- Small rates of usage- Non application due to the inexistence of enough
knowledge of the techniques
JUSTIFICATION
bull In Europe bulllt10 of all endoscopically diagnosed gastric cancers are in an earlier stage of development 4
bull In Japan bull50 of all endoscopically diagnosed gastric cancers are in an earlier stage of development 4
4 Roukos DH Current advances and changes in treatment strategy may improve survival and quality of life in patients with potentially curable gastric cancer Academic Department of Surgery Medical School University of Ioannina Greece Ann Surg Oncol 1999 Jan-Feb6(1)46-56
RESEARCH QUESTION
What is the current use of endoscopic resection techniques (EMRESD) in european centers
STUDY DESIGN- Observational study- cross-sectional study
-
PARTICIPANTS
Target populationEuropean endoscopic unitscenters
Sampling methodNon-random
Members of the national societies of endoscopy
European centers that published papers indexed in Pubmed during 2007 and 2008 in
Gastrointestinal Endoscopy journal Endoscopy journal
DATA COLLECTION AND VARIABLES
bull Online questionnaires regarding the following variablesbull Number and tipe of proceduresbull Completeness of procedurebull Complicationsbull Type of lesionsbull Number and expertise of operators
bull Questionnaire will be completed and used by the participants using Medquest developed on SBIM-FMUP
GANTT CHART
GANTT CHART
GANTT CHART
Expected results
bull Final product paper with the results of the study
- Earlier perspectives
- Small rates of usage- Non application due to the inexistence of enough
knowledge of the techniques
RESEARCH QUESTION
What is the current use of endoscopic resection techniques (EMRESD) in european centers
STUDY DESIGN- Observational study- cross-sectional study
-
PARTICIPANTS
Target populationEuropean endoscopic unitscenters
Sampling methodNon-random
Members of the national societies of endoscopy
European centers that published papers indexed in Pubmed during 2007 and 2008 in
Gastrointestinal Endoscopy journal Endoscopy journal
DATA COLLECTION AND VARIABLES
bull Online questionnaires regarding the following variablesbull Number and tipe of proceduresbull Completeness of procedurebull Complicationsbull Type of lesionsbull Number and expertise of operators
bull Questionnaire will be completed and used by the participants using Medquest developed on SBIM-FMUP
GANTT CHART
GANTT CHART
GANTT CHART
Expected results
bull Final product paper with the results of the study
- Earlier perspectives
- Small rates of usage- Non application due to the inexistence of enough
knowledge of the techniques
STUDY DESIGN- Observational study- cross-sectional study
-
PARTICIPANTS
Target populationEuropean endoscopic unitscenters
Sampling methodNon-random
Members of the national societies of endoscopy
European centers that published papers indexed in Pubmed during 2007 and 2008 in
Gastrointestinal Endoscopy journal Endoscopy journal
DATA COLLECTION AND VARIABLES
bull Online questionnaires regarding the following variablesbull Number and tipe of proceduresbull Completeness of procedurebull Complicationsbull Type of lesionsbull Number and expertise of operators
bull Questionnaire will be completed and used by the participants using Medquest developed on SBIM-FMUP
GANTT CHART
GANTT CHART
GANTT CHART
Expected results
bull Final product paper with the results of the study
- Earlier perspectives
- Small rates of usage- Non application due to the inexistence of enough
knowledge of the techniques
PARTICIPANTS
Target populationEuropean endoscopic unitscenters
Sampling methodNon-random
Members of the national societies of endoscopy
European centers that published papers indexed in Pubmed during 2007 and 2008 in
Gastrointestinal Endoscopy journal Endoscopy journal
DATA COLLECTION AND VARIABLES
bull Online questionnaires regarding the following variablesbull Number and tipe of proceduresbull Completeness of procedurebull Complicationsbull Type of lesionsbull Number and expertise of operators
bull Questionnaire will be completed and used by the participants using Medquest developed on SBIM-FMUP
GANTT CHART
GANTT CHART
GANTT CHART
Expected results
bull Final product paper with the results of the study
- Earlier perspectives
- Small rates of usage- Non application due to the inexistence of enough
knowledge of the techniques
DATA COLLECTION AND VARIABLES
bull Online questionnaires regarding the following variablesbull Number and tipe of proceduresbull Completeness of procedurebull Complicationsbull Type of lesionsbull Number and expertise of operators
bull Questionnaire will be completed and used by the participants using Medquest developed on SBIM-FMUP
GANTT CHART
GANTT CHART
GANTT CHART
Expected results
bull Final product paper with the results of the study
- Earlier perspectives
- Small rates of usage- Non application due to the inexistence of enough
knowledge of the techniques
GANTT CHART
GANTT CHART
GANTT CHART
Expected results
bull Final product paper with the results of the study
- Earlier perspectives
- Small rates of usage- Non application due to the inexistence of enough
knowledge of the techniques
GANTT CHART
GANTT CHART
Expected results
bull Final product paper with the results of the study
- Earlier perspectives
- Small rates of usage- Non application due to the inexistence of enough
knowledge of the techniques
GANTT CHART
Expected results
bull Final product paper with the results of the study
- Earlier perspectives
- Small rates of usage- Non application due to the inexistence of enough
knowledge of the techniques
Expected results
bull Final product paper with the results of the study
- Earlier perspectives
- Small rates of usage- Non application due to the inexistence of enough
knowledge of the techniques
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