Endoscopical Resection for Early Gastric Cancer Measuring 1 cm or Less in Size Tsutomu Hamada 1 1Department of Gastroenterolgy, Juntendo University, School Keyword: 早期胃癌 , 内視鏡的切除 , 胃癌再発 pp.255-263
Published Date 1991/3/25
DOI https://doi.org/10.11477/mf.1403102477
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 Endoscopic therapy of gastric cancer has been mainly performed in non resectable cases of early cancer, for example in patients having severe complications, in the high-aged group and in patients refusing an operation. Recently, endoscopic polypectomy has made it possible to doradical resection for small polypoid cancers in resectable cases. Furthermore, we resected small depressed cancers which were diagnosed as cancers limited to the mucosa. The indication to perform the endoscopical resection instead of surgery was determined foreach cancer macroscopically (x-ray and endoscopy) as follows; 1. Measuring less than l cm in size (elevated and depressed type) 2. Not accompanied with converging folds, and having shallow depression without mound-like elevation (depressed-type).

 According to those indications, 23 elevated, and 38 depressed-type early gastric cancers were resected by endoscopic polypectomy usingh ighfrequency electric current, and the resected specimens were surveyed pathologically. Except for l case, 57 differentiated-type cancers were limited to the mucosa, but one of four cases of undifferentiated-type cancers had invaded the submucosa. Relationship between the prognosis (the average follow-up interval was 21 months) and the histological distance from the edge of the specimen to the margin of the cancer was discussed. None of 34 cases having a distance of more than 2 mm was recurrent. On the other hand, 3 of 17 cases having a distance of less than 2 mm were recurrent at the site of resection, and 4 of 10 cases where the cancer obviously had spread to the edge of the specimen were found to have recurred. Most of all the carcinomas resected completely, but those in the gastric body were resected incompletely.

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