{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T00:08:05Z","timestamp":1775088485689,"version":"3.50.1"},"reference-count":28,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,1,31]],"date-time":"2025-01-31T00:00:00Z","timestamp":1738281600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Samsung Medical Center","award":["SMO124074"],"award-info":[{"award-number":["SMO124074"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Objectives: The indications for endoscopic submucosal dissection (ESD) for gastric adenoma and gastric cancer have expanded, leading to an increase in the number of patients with high procedural complexity. Post-ESD perforations prolong hospital stays and increase costs. However, no studies have focused on detecting micro-perforations during ESD. This study aimed to identify signs of perforation using abdominal ultrasound during gastric ESD. Materials and methods: This pilot study analyzed 50 patients who underwent abdominal ultrasound (VScan Air\u2122, GE Healthcare) during ESD at Samsung Medical Center (March 2023\u2013July 2024). Perforation was assessed via ultrasound, and post-procedure X-rays were performed for three days to detect free air. Results: Among 50 patients (median age 60, 76.1% male), the median procedure time was 60 min. Lesions were most common in the antrum (30.4%) and lesser curvature (17.4%). Pathology revealed 32.6% well-differentiated and 10.9% moderately differentiated adenomas, with 15.2% showing high-grade dysplasia. Free air was detected in three patients after procedures involving the body wall of the stomach. Abdominal US showed indirect signs of perforation, including an abnormal peritoneal line, hyperechoic shadowing, and an absence of normal gas patterns, confirmed by X-ray. Conclusions: Abdominal US is a simple, useful tool for rapid detection of perforation during ESD, enabling timely intervention. Further multicenter studies are needed to confirm these findings.<\/jats:p>","DOI":"10.3390\/diagnostics15030335","type":"journal-article","created":{"date-parts":[[2025,1,31]],"date-time":"2025-01-31T04:05:47Z","timestamp":1738296347000},"page":"335","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Pilot Study on Detecting Perforation with Abdominal Ultrasound During Gastric Endoscopic Submucosal Dissection"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2149-7979","authenticated-orcid":false,"given":"Ji Eun","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7263-0867","authenticated-orcid":false,"given":"Jeayoun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tae Se","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yang Won","family":"Min","sequence":"additional","affiliation":[{"name":"Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4271-7205","authenticated-orcid":false,"given":"Hyuk","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Byung-Hoon","family":"Min","sequence":"additional","affiliation":[{"name":"Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun Haeng","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Poong-Lyul","family":"Rhee","sequence":"additional","affiliation":[{"name":"Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jae J.","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1111\/den.13883","article-title":"Guidelines for endoscopic submucosal dissection and endoscopic mucosal resection for early gastric cancer (second edition)","volume":"33","author":"Ono","year":"2021","journal-title":"Dig. 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