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Indication for Gastrectomy on the Basis of Histological Findings of the EMR Specimen Atsunobu Misumi 1 , Ubehiko Honmyo 1 , Shogo Nakano 1 , Masayuki Inada 1 , Akitoshi Murakami 1 1The Second Department of Surgery, School of Medicine, Kumamoto University Keyword: 胃癌 , EMR , 内視鏡的治療 , 根治の評価 , 根治性の判定基準 , 手術適応 pp.1627-1639
Published Date 1998/11/25
DOI https://doi.org/10.11477/mf.1403103871
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 The absence of lymph node metastasis is the necessary condition indicating the use of radical local treatment of gastric cancer, including EMR. In addition, the radical local treatment is not approved without com-plete resection of the lesion. The greatest merit of local resection is that it enables histological examination of the resected specimen as in the case of surgical resection. The purpose of histological examination of the EMR specimen is to evaluate radicality of the treatment by confirming the lesion to be mucosal cancer and completely resected with surgical margins of 2 mm or more. Therefore, even when the indication for EMR is strictly established, the physician cannot ignore the possibility of cases unsuitable for EMR, because evaluation of depth of invasion is not always correct prior to EMR. Because of that, radical EMR is approved by judging the of histological findings of the EMR specimen. Radical EMR is the first choice of the treatment for early gastric cancer. It is, however, a treatment against only early gastric cancer. If EMR is not judged as radical on the basis of post treatment histological examination, then the physician should advance promptly to subsequent treatment ensuring greater radicality such as laparoscopic local excision or open surgery gastrectomy.


Copyright © 1998, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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