早期胃癌に対する内視鏡治療の効果判定―特に不完全切除例の効果判定

Criteria for Evaluating the Need for Multiple Resection after Imperfect Resection during Endoscopic Therapy for Early Gastric Cancer

要旨　内視鏡的治療における効果判定，特に不完全切除例に対する分割切除での効果判定について明らかにした．完全切除例においては，その評価ができた時点で局所根治が証明される．不完全切除例においては，1年目の内視鏡検査で遺残がみられないものは，局所根治が得られたと判定することができる．その時点で，遺残が証明された病変は，20mm以下のmにとどまる病変であるため，追加の内視鏡的治療で根治効果が得られる．

　Endoscopic therapy (by strip biopsy) for early gastric cancer sometimes requires repetition. Multiple resection is necessary if the result of the first resection is imperfect.

　To evaluate whether further resection is necessary or not, long-term follow-up (one year after treatment) should be carried out using endoscopic diagnosis.

　If no residual lesion is observed at this time, it can be presumed that the primary resection was perfectly effective.

　If a residual lesion is detected at this time, and the lesion is less than 20 mm in length and limited to the mucosal layer, additional endoscopic therapy should be carried out to treat the imperfectly resected lesion curatively.