Change in gastric emptying eight weeks after endoscopic submucosal dissection in patients with early gastric cancer

Background: Gastric emptying after endoscopic submucosal dissection (ESD) for early gastric cancer is not clear. The aim of this study was to evaluate changes in gastric emptying from before ESD to 8 weeks after ESD. Methods: In total, 54 patients with early gastric cancer were enrolled in this study. A breath test with carbon 13 ((13)C) was conducted before ESD and at 1 and 8 weeks after ESD. The T(lag) and T(1/2) values were analyzed at each time point. The primary outcomes were the changes in the T(lag) and T(1/2) values from before ESD to 1 and 8 weeks after ESD. The secondary outcomes were the factors associated with the changes in the T(lag) and T(1/2) values. Results: Gastric emptying was delayed at 1 and 8 weeks after ESD compared with before ESD (T(lag) P = 0.002, P < 0.001; T(1/2) P = 0.005, P = 0.001, respectively). The changes in the T(lag) and T(1/2) values from before ESD to 1 week after ESD were greater for proximal stomach lesions than for distal stomach lesions (P = 0.028, P < 0.001). Proximal stomach lesions were identified as the significant factor that influenced changes in the T(lag) and T(1/2) values from before ESD to 1 week after ESD in the multivariate analyses (T(lag) P = 0.003, T(1/2) P = 0.005). Conclusions: ESD induced delayed gastric emptying until 8 weeks after ESD. Proximal stomach lesions were also associated with decreased emptying 1 week after ESD.