Some Considerations on Endoscopic Radical Resection of Early Gastric Cancer Kunio Okajima 1 , Shin-ichi Yamada 1 , Hiroshi Isozaki 1 , Tatsuhiro Nakajima 1 , Eiji Nakata 1 1Department of Surgery, Osaka Medical College Keyword: 胃癌の治療 , 早期胃癌 , 内視鏡的治療 pp.371-377
Published Date 1991/4/25
DOI https://doi.org/10.11477/mf.1403102505
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 In order to accomplish endoscopic radical resection of early gastric cancer, the following requirements have to be satisfied: (1) absence of lymph node metastasis, and (2) complete resection of multiple foci of cancer frequently seen in cases of early gastric cancer. Bearing these in mind, we recently analyzed 482 cases of early gastric cancer treated at our department. The following results were obtained.

 1. Characteristics of early gastric cancer without lymph node metastasis: Lymph nodes were negative for metastasis in cases with the following features: (a) macroscopically tumor size was less than 10 mm in diameter; (b) protruded or elevated type (type Ⅰ, Ⅱa, Ⅰ+ Ⅱa) with the longest diameter less than 20 mm (Fig. 2).

 2. Diagnosis on the depth of cancer invasion: Because endoscopic radical resection of gastric cancer is feasible only for early gastric cancer, accurate assessment on the depth of cancer invasion preoperatively is mandatory.

 3. Diagnosis on multiple cancer foci: Because early gastric cancer (in particular minute gastric cancer) frequently takes the form of multiple cancers, preoperative detection of these multiple foci is essential to complete resection. After resection, careful follow-up is necessary so as not to overlook local recurrence and residual foci of cancer.

Copyright © 1991, Igaku-Shoin Ltd. All rights reserved.


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