早期胃癌の水平方向への拡がりに対する胃粘膜切除術―ERHSE法の評価

The Valuation for Enblock Resection and Piecemeal Resection by ERHSE in Early Gastric Cancer

要旨　ERHSE(endoscopic resection with local injection of hypertonic saline-epinephrine：ERHSE)を施行した早期胃癌m癌346例について①一括切除率を部位・肉眼型・病変長径別(水平方向への拡がり)に，②完全切除率を一括・分割切除と部位・肉眼型・病変長径別に検討した．その結果，全349例の一括切除率は56.2％であり，肉眼型では陥凹型で，部位別では幽門側ほど，病変長径別では病変長径が短いほど一括切除率は高くなる．しかし完全切除率は全症例では95.7％であり一括切除では97.4％，分割切除で93.5％と両群間に有意差はない．完全切除率は一括切除と分割切除において肉眼型・部位・病変長径別で差はなかった．結論としてERHSEでは分割切除が治癒切除を阻害する要因とはならない．

　A total of 346 patients with early gastric cancer underwent treatment using the ERHSE method.

　The rate of enblock resection were high in tumors whose macroscopic appearance was “depressive type”, which had A distribution of CMA classification, and whose size was 1～10 mm in diameter. The curability was 95.7％ in all, with 97.4％ in enblock resection and 93.5％ in piecemeal resection. There was no difference in curability between tumors removed by enblock resection and those removed by piecemeal resection.

　Conclusion: piecemeal resection by ERHSE does not lower the curability rate for early gastric cancer therapy.