Possiblity of Complete Resection by Endoscopic Mucosal Resection using the Piecemeal Method Tsutomu Humada 1 1Department of Gastroenterology, The Social Health Insurrance Medicat Center Keyword: 早期胃癌 , 内視鏡的粘膜切除 , 分割切除 , マーキング , 遺残再発 pp.1609-1617
Published Date 1998/11/25
DOI https://doi.org/10.11477/mf.1403103868
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 Recently, the size of cancers treated by endoscopic mucosal resection (EMR) has became larger and larger because the piecemeal method has made it possible to resect cancers more than 2 cm in size. To discuss whether such cancers have been resected completely or not,74 cases with 74 lesions of early gastric cancer removed by EMR using the piecemeal method in our department were analyzed and the results were as follows:

1) During EMR using the piecemeal method the withdrawal of all resected specimens was hard, especially when there were more than 4 pieces.

2) The recurrence rate was 10.5% of cancers resected in two pieces, 31.2% in three pieces, 0% in four pieces, 8.3% in five pieces, and 25% in more than 6 pieces, so there was no correlation between recurrence and the number of pieces in which the cancers were resected.

3) On the other hand, the rate of recurrence was 8.5% of the cases in which the marking procedure around the cancer was carried out before EMR and 29.6 of the cases in which the marking procedure was not carried out.

 It was conpidered that the marking procedure is very important to remove the cancers completly, but the pathological survey of the specimens resected by piecemeal method is unable to determine whether the cancers have been resected completely or no.

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