Dr. Clarence Wong (Photo supplied by Alberta Health Services)

By Emily Keller

Endoscopic Submucosal Dissection

Innovative stomach cancer procedure earns high praise from Grande Prairie patient

Jun 25, 2020 | 2:39 PM

A minimally invasive procedure to treat early-stage stomach and intestinal cancer is now being done at the Royal Alexandra hospital in Edmonton.

The procedure is being done by a team at the hospital, led by Dr. Clarence Wong.

Chris Partington, a Grande Prairie man, says that he was given the option of having the endoscopy instead of more typical options for those with these forms of cancer.

“I was diagnosed with stomach cancer, and the original decisions from the surgeons was to do a bisection of the stomach, or even a stomach removal in order to remove the cancer. I wasn’t crazy about that, and they (the surgeons) did tell me and introduced me to Dr. Wong, and he had been doing this new type of procedure.”

The procedure, called an Endoscopic Submucosal Dissection (ESD), is non-surgical, and is performed by a specially trained gastroenterologist. Patients undergoing the procedure receive sedation, and the gastroenterologist moves an endoscope, which is a long tube with a light and camera attached to it, through the mouth and into the gastrointestinal tract to where the cancerous tumour is located.

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The tumour is then removed entirely with some surrounding tissue with specialized instruments that are inserted through the endoscope.

Typically, treatment for cancers like this are surgical removal, radiation and/or chemotherapy. The recovery time for the ESD procedure is also shorter, with patients being able to leave after the procedure or to have to stay at the hospital for a short time. The procedure itself takes between one and four hours.

Dr. Wong first received the training at multiple medical centres, including ones in Chicago, Baltimore and Miami, from endoscopists from the Japanese Society of Gastroenterology and American Association of Gastrointestinal Endoscopy. He then performed the procedure for the first time at the Royal Alex in an operating room. The procedure is now done in the outpatient endoscopy unit.

A photo of the unit where the ESD procedure is done. (Supplied by Alberta Health Services)

Partington says that Dr. Wong has great bedside manner and made him feel informed and comfortable with the procedure. He says that after his procedure, he had little pain and only had to follow a diet for a short period of time.

“I got to keep my stomach, and my quality of life, because of that, has been amazing,” said Partington. “It would have been pretty tough to go the rest of my life without a stomach.”

The team involved in the procedures include Dr. Wong, gastroenterologists, surgeons, anesthetists, pathologists, nurses, and other professional care staff.

Patients do need to meet certain qualifications for the procedure, including the type, extent, and stage of the cancer, but Alberta Health Services says that if treated in its early stages, GI tract cancers can be cured.

The procedure has now been done on 15 more patients at the Royal Alex since 2018, with all recent patients being discharged home within 24 hours of the procedure. None required readmission.

“I would suggest to anybody who’s going through a similar situation to definitely try that (the procedure).”