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Recomendación 1:
Se recomienda el tratamiento de erradicación para Helicobacter Pylori para la prevención de lesiones gástricas malignas. (Recomendación fuerte a favor, certeza moderada de la evidencia)

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Recomendación 1:
Se recomienda el uso de la cromoendoscopía virtual en comparación a la endoscopia de luz blanca para el diagnóstico de cáncer gástrico temprano. (Recomendación fuerte a favor, certeza moderada de la evidencia)

BPC 1:
Mientras se desarrolle la implementación de la cromoendoscopía virtual se recomienda continuar con las técnicas diagnósticas habituales incluyendo la endoscopía convencional con luz blanca, entre otras, al considerarse que cuentan con nivel de precisión diagnóstica aceptable.

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Recomendación 1:
No se recomienda el uso de la resonancia magnética para el estadiaje loco-regional de los pacientes con cáncer gástrico temprano. (Recomendación fuerte en contra, certeza baja de la evidencia)

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Recomendación 1:
Se sugiere el uso de la ultrasonografía endoscópica para el estadiaje loco-regional de los pacientes con cáncer gástrico temprano en los establecimientos en los que se encuentre disponibles. (Recomendación condicional a favor, certeza baja de la evidencia)

BPC 1:
En tanto se desarrolle la implementación de la ultrasonografía endoscópica se recomienda realizar la tomografía espiral multicorte, y en lo preferible incorporar el protocolo de hidrotem, para el estadiaje loco-regional de los pacientes con cáncer gástrico temprano.

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En base a las dos recomendaciones anteriores se decidió no discutir esta comparación dado que la ultrasonografía endoscópica es el método de elección frente a la resonancia magnética.

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Recomendación 1:
Se recomienda la disección submucosa para el manejo endoscópico del cáncer gástrico temprano como parte del manejo multidisciplinario del cáncer gástrico temprano. (Recomendación condicional a favor, certeza baja de la evidencia)

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Recomendación 1:
Se recomienda el tratamiento endoscópico frente al quirúrgico en pacientes con cáncer gástrico temprano siguiendo los estándares internacionales. (Recomendación condicional a favor, certeza baja de la evidencia)

BCP 1:
Use la resección endoscópica para el tratamiento de las lesiones neoplásicas gástricas superficiales que presentan un riesgo muy bajo de metástasis ganglionares.

BCP 2:
Use la resección endoscópica mucosa para lesiones menores de 10-15 mm con una probabilidad muy baja de histología avanzada (Paris 0-IIa). Mientras que la disección endoscópica submucosa sería el tratamiento de elección para la mayoría de las lesiones neoplásicas gástricas superficiales.

BCP 3:
La resección endoscópica debe realizarse cuando la probabilidad de metástasis en los ganglios linfáticos es extremadamente baja y el tamaño y el sitio de la lesión son susceptibles de resección en bloque.

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Recomendación 1:
Se recomienda un programa de seguimiento de lesiones premalignas gástricas a través de la endoscopía digestiva alta, el cual debe ser monitorizado permanentemente para sustentar su efectividad y seguridad. (Recomendación fuerte a favor, certeza baja de la evidencia)

BPC 1:
El tiempo de seguimiento de lesiones premalignas gástricas a través de la endoscopía digestiva alta debe de ser hasta los 10 años.

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Recomendación 1:
Se recomienda un programa de seguimiento endoscópico posterior a la resección endoscópica en pacientes con Ca gástrico temprano. (Recomendación fuerte a favor, certeza baja de la evidencia)

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