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Practice of Endoscopic Mucosal Resection: A Survey to Endoscopic Units in Europe Class 15 – FMUP – 2008/2009 19th December 2008 André Carvalho, Ana Morais, Clara Ferreira, Francisco Mourão, João Santos, José Martins, Mariana Formigo, Manuel Cruz, Raquel Santos Mário 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 Spread on the scientific interest 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-Feb;6(1):46-56; 1 BACKGROUND Detection Stage of development Early stage Advanced stage Different approaches on the treatment BACKGROUND • EMR and ESD – an answer ! Japan, 1980 described in 1984 • Early gastric cancer (mucosa/submucosa) • Alternative to surgery! BACKGROUND Advantages2: •Less morbidity Better •Less mortality quality of life •Less invasive •Posterior histological analysis •Allows posterior surgery Disadvantages3: • High incidence of complications •Requires high endoscopy skills 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 7;14(13):1984-9 2 Tanaka M, Ono H, Hasuike N; Endoscopic submucosal dissection of early gastric cancer; Takizawa K.Division of Endoscopy and Gastrointestinal Oncology, Shizuoka Cancer Center Hospital, Shizuoka, Japan 3 JUSTIFICATION • In Europe: •<10 % of all endoscopically diagnosed gastric cancers are in an earlier stage of development 4 • In Japan: •50 % 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-Feb;6(1):46-56; RESEARCH QUESTION What is the current use of endoscopic resection techniques (EMR/ESD) in european centers? STUDY DESIGN - Observational study - cross-sectional study - PARTICIPANTS Target population European endoscopic units/centers Sampling method: Non-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 • Online questionnaires regarding the following variables: • Number and tipe of procedures • Completeness of procedure • Complications • Type of lesions • Number and expertise of operators • Questionnaire will be completed and used by the participants using Medquest, developed on SBIMFMUP. GANTT CHART GANTT CHART GANTT CHART Expected results • 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