A Study of the Efficiency of Additional Endoscopic Treatment for Residual and Recurrent Cancer after Endoscopic Mucosal Resection (EMR) for Early Gastric Cancer Ryoichi Misaka 1 , Minoru Kawaguchi 1 , Hironobu Umezawa 1 , Yuzuru Tani 1 , Yutaka Handa 1 1The Fourth Department of Internal Medicine, Tokyo Medical College Keyword: EMR , 遺残再発癌 , 内視鏡的追加治療 , Nd-YAGレーザー pp.1719-1725
Published Date 1998/12/25
DOI https://doi.org/10.11477/mf.1403103888
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 To examine the effect of endoscopic mucosal resection (EMR) and additional treatment for early gastric cancer, we studied the endoscopic findings, the histopathological findings, the additional treatments and the process after resection in 152 patients with 170 lesions of early gastric cancer treated by EMR since 1988 to December 1997.

 The rate of complete resection among 170 lesions was 62.4% (106/170) and we performed surgical operations on 12 cases with invasion to the submucosal layer or cut end (+++).

 No recurrent case was recognized among the cases in which complete resection was confirmed by histological examination of the resected specimen. We treated the residual and recurrent cancer by ① re-EMR, ② laser therapy, ③ heater probe or ④ local injection of ethanol. We examined the additional endoscopic treatment for 52 lesions, and 50 of them showed negative for cancer diagnosed through endoscopic biopsy. Two recurrent cases were recognized more than one year after EMR, (1) Ⅱc (tubl) recurred after one year and a half, (2) Ⅱc (tubl) recurred after two years. Both of them had received EMR as the primary treatment and heater probe as the additional treatment. These recurrent cases were completely resected with re-EMR. The rate of efficiency or cure after the additional endoscopic treatment was 98.1% (51/52). Including both the complete resected cases and the additional treatment cases, the rate of efficiency or cure was 92.4% (157/170). We performed re-EMR and added laser therapy in the cases with cut-end positivity for cancer and the rate of cure was as high as 92.4%.

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