Figure 1.

A 91-year-old man presenting a 0-IIa lesion measuring 25 mm in the posterior wall of the upper gastric body, with por2 > sig (preoperative biopsy). Although the lesion did not meet the inclusion criteria, en bloc resection was performed by ESD as per the wishes of the patient's family. Pathological findings included por2 > sig, 0-IIa, 18 × 18 mm, pT1b2 (SM2 ≧800 μm), UL (−), ly (+), v (+), HM0, and VM1. The procedure was deemed a noncurative resection. Upon performing additional surgery, the subject developed postgastrectomy syndrome 1 month after surgery, which led to the gradual deterioration of his nutritional status due to impaired food intake. Seven months after surgery, the subject went into septic shock caused by a urinary tract infection and passed away. ESD = endoscopic submucosal dissection.