ESD for early gastric cancer: a 77-year-old patient flew back to Shenzhen to keep her stomach

The case in brief

• checkJune 2026: a 77-year-old woman (referred to in the hospital's account as Ms Wang, a pseudonym) had returned from New Zealand and was travelling in China. Persistent poor appetite and nausea brought her to the gastroenterology outpatient clinic of Shenzhen Qianhai Taikang Hospital.
• checkGastroscopy, performed by Dr Wang Chen (chief physician), showed high-grade dysplasia of the gastric antrum mucosa — a precancerous lesion — together with fundic gland polyps.
• checkShe was in Beijing at the time, where treatment scheduling was uncertain and her return flight to New Zealand was already booked. After weighing the options she flew back to Shenzhen for treatment.
• checkAfter contraindications were excluded, Prof. Li Chujun performed endoscopic submucosal dissection (ESD). Pathology confirmed a 6 x 6 mm early well-differentiated adenocarcinoma with no vascular or lymphatic involvement and clear resection margins.
• checkShe recovered well after surgery, was discharged and returned to New Zealand.

How the problem was found

• checkSymptoms were ordinary: a poor appetite and a feeling of nausea — the kind of complaint easily attributed to a recurrence of ordinary stomach trouble.
• checkGastroscopy was arranged as part of the work-up, not because of any alarming sign.
• checkThe pathology diagnosis was high-grade dysplasia of the gastric antrum mucosa — abnormal cells confined to the surface layer, described by the hospital as a precancerous lesion.
• checkFundic gland polyps were also noted during the same examination.
• checkThe hospital's own account records that the endoscopy physician telephoned the patient with the result, explained what it meant and advised prompt follow-up — the patient described that call as the moment she stopped feeling she was facing it alone.

Why ESD rather than open surgery

• checkFor early lesions confined to the gastric mucosa, ESD is an established treatment: the lesion is lifted and dissected away from below using an endoscope, with no abdominal incision.
• checkThe aim is complete removal of the lesion while preserving as much of the stomach's normal structure and function as possible — which matters for nutrition and quality of life afterwards.
• checkThe trauma is smaller than open or laparoscopic gastrectomy, but it is still surgery: the hospital's own explanation stresses that recovery takes time.
• checkProf. Li Chujun, who performed the procedure, has worked in gastrointestinal endoscopy for more than 20 years, focusing on endoluminal (no open chest or abdomen) minimally invasive treatment of gastrointestinal polyps and early gastrointestinal cancers.

What the pathology report showed

• checkSize and site: a 6 x 6 mm lesion in the gastric antrum.
• checkType: early well-differentiated adenocarcinoma — an early cancer, not an advanced one.
• checkVascular and lymphatic involvement: none reported. This is a key prognostic finding, since it bears on the risk of spread.
• checkResection margins: clear.
• checkAlso found: fundic gland polyps in the gastric body and fundus — a separate, common finding recorded in the same report.

Early-cancer screening and advanced endoscopy at the hospital

• checkThe hospital describes a standardised early-cancer screening pathway, including painless (sedated) gastroscopy and colonoscopy, with targeted screening for high-risk groups.
• checkRoutine advanced endoscopy includes chromoendoscopy and magnifying endoscopy, APC (argon plasma coagulation), EMR (endoscopic mucosal resection), ESD (endoscopic submucosal dissection), POEM (peroral endoscopic myotomy), STER (submucosal tunnelling endoscopic resection) and ERCP (endoscopic retrograde cholangiopancreatography).
• checkIn practical terms, a suspicious lesion found on a screening gastroscopy can usually be assessed and, where suitable, treated endoscopically in the same programme rather than referred elsewhere.

Care after the procedure

• checkThe hospital's account describes daily ward rounds and continuous follow-up of the patient's condition after the ESD.
• checkNursing staff explained post-procedure care and monitored changes closely.
• checkThe patient recovered well, was discharged, and has since returned to New Zealand.
• checkThe hospital's release quotes the thank-you letter she left behind: “纸短情长，谢意绵长。千言万语道不尽心中的感激与敬意。”

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