Disección endoscópica de submucosa vs gastrectomía subtotal en pacientes con cáncer gástrico temprano: Revisión sistemática

Abstract

Introduction: Early gastric cancer (EGC) is a condition that affects the submucosal layer of the stomach, with or without lymph node involvement. It represents the second leading cause of death related to neoplasia worldwide. This systemic review is relevant in knowing the therapeutic approaches to early gastric cancer and determining the most appropriate procedure. Methodology: The review follows the PRISMA 2020 guidelines. Scientific articles on EGC, subtotal gastrectomy (STG), and endoscopic submucosal dissection (ESD) published in the last five years in Spanish and English were selected. The search was performed in databases such as PubMed and Web of Science, using DeCS and MeSH. The studies were evaluated for their risk of bias using the Newcastle-Ottawa assessment tool. Results: Studies covering survival rates, postoperative complications, and recurrence of EGC in patients undergoing ESD and STG were included. A total of 79 articles were obtained, of which 53 studies were excluded for not meeting the inclusion criteria, leaving 26 articles. The studies show that ESD has a survival rate of 92% and STG of 90.2%. However, recurrence was 1.7% in ESD and 0.6% in STG. Conclusion: ESD offers significant advantages over STG in terms of survival and quality of life in patients with EGC. However, STG remains a safe and effective option. The treatment decision should be based on an individualized assessment of each patient