Fig 1.
Flow chart of the prospective trial.
Seventy-two patients diagnosed with early gastric cancer at Ehime Rosai Hospital and Kagawa University Hospital were included. From 10 endoscopists, the 2 endoscopists engaged in the ESD were excluded. Three endoscopists were randomly extracted before every ESD by the envelope method from among 8 endoscopists who were not informed of this study at all. These 3 endoscopists in turn attached the same resected lesion to a specimen board, measured the maximum resection diameter and tumor size, and recorded it.
Table 1.
Characteristics of patients.
Fig 2.
Photograph of the Case 27 lesion actually attached by 3 endoscopists.
The maximum resection diameters shown by the yellow arrow are 48, 45, and 40 mm, showing variation. The orthogonal diameters shown by the blue arrows also vary. The tumor sizes (green arrows) were also different from each other.
Fig 3.
Comparison among 3 endoscopists.
a: Comparisons of maximum resected specimen diameters among 3 groups resulted in significant differences (Kruskal Wallis H- test, H = 6.397, P = 0.040). b: Comparisons of tumor sizes among 3 groups resulted in significant differences (H = 6.917, P = 0.031).
Fig 4.
Equally magnified photograph attachment method.
After the picture was taken in front of the lesion with measuring forceps to confirm that the photograph was equally magnified (yellow arrows). The lesion was photographed to record the size (green arrow indicates the tumor diameter) and shape of the lesion in vivo and printed. The resected specimen was attached as the photograph shows (blue curved arrow).