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Importance of X-ray Examination in the Diagnosis of Gastric Neoplasms―With Special Reference to Surgical Treatment Yoshihide Otani 1 1Department of Surgery, Keio University School of Medicine Keyword: 胃癌 , X線診断 , 縮小手術 , 浸潤範囲 , 残胃癌 pp.855-862
Published Date 2003/5/25
DOI https://doi.org/10.11477/mf.1403100849
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 We have described the significance of X-ray examination in the diagnosis of gastric cancer and stromal tumor from the standpoint of surgical treatment. Advantages of X-ray examination over endoscopic examination are;

1)It points out the invasion front of wide-spread type of early cancer

2)It enables diagnosis of the depth of invasion of SM and MP cancer

3)It enables precise comparison of the lesion with the whole stomach

4)In combination with endoscopic examination, it enables detection of a second lesion.

5)It points out the lesions in the postoperative or post EMR stomach

These points are useful in the selection of surgical procedures. Dr. Theodor Billroth first succeeded in carrying out distal gastrectomy with his Billroth I anastomosis for a gastric cancer patient, in 1881. For a long time, two types of gastric cancer surgery, such as distal subtotal gastrectomy and total gastrectomy, have been performed. In recent years, with the increasing number of cases with early gastric cancer, limited surgery such as wedge resection, sleeve resection, and pylorus-preserving distal gastrectomy are becoming more popular for the treatment of patients with early gastric cancer or stromal tumor. Precise diagnosis of the invasion area and depth of invasion are more necessary for these limited surgeries than for conventional surgical procedures.

 We would like to emphasize that both x-ray examination and endoscopic examination are important for preoperative precise diagnosis of gastric neoplasms. The combination of both examinations enables, to a considerable extent, the selection of safe and curative surgical procedures.


Copyright © 2003, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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