Preoperative Diagnosis of Early Gastric Cancer for ESD―Diagnosis of Large Superficial-type Carcinoma by Conventional and Dye Endoscopy Ken Ohata 1 1Departments of Gastroenterology, JR Tokyo General Hospital Keyword: 早期胃癌 , 適応拡大病変 , ESD , 色素内視鏡 pp.753-760
Published Date 2005/4/25
DOI https://doi.org/10.11477/mf.1403100108
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In these days it has become possible to resect at once large lesions spreading superficially by using the endoscopic submucosal dissection(ESD)method. So it is now all the more important to diagnose the border line of such a lesion correctly. We studied whether it is useful or not to use the ordinary diagnostic method for determining the border line of lesions, using the dying method for two such large lesions. The result we obtained was that marking by the ordinary method using dying endoscopy coincided almost exactly with the margin which was diagnosed pathologically. Because of this we conclude that the ordinary method including the dying method which has been used so far for determining the border line of the lesion is sufficient for large lesion where ESD is indicated. In our 209 cases of ESD usage the resected margin is almost over 2 cm outside the pathological margin of the lesion, no matter what the size of the lesion may be, so we can conclude that ESD is a safe enough technique of endoscopic resection because it operate with margin of safety to avoid any residual cancer. Even in cases of resection of undifferentiated cancer we think that ESD is the safest method of resection to avoid residual cancer.

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