Endoscopic Resection: For the Purpose of a Curative Treatment of Early Gastric Cancer Masaya Tanaka 1 , Kiyoshi Ashida 1 , Eiji Umegaki 1 , Saburo Ohshiba 1 1The Second Department of Internal Medicine, Osaka Medical College Keyword: 早期胃癌 , 内視鏡的切除 , 根治術 pp.87-98
Published Date 1993/2/26
DOI https://doi.org/10.11477/mf.1403106089
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 Endoscopic resection (ER) can be a curative treatment of early gastric cancer in selected patients because resected specimens can be histologically examined. ER may be regarded as the least invasive modality of curative surgeries. To investigate the indications for ER as a curative treatment of early gastric cancer, we analyzed retrospectively 48 patients (50 lesions) of early gastric cancer and 31 patients (33 lesions) of gastric adenoma who underwent ER in our department over the last 6 years. Resected specimens were histologically examined at 2mm intervals. A case without cancer cells on the surface of a cutting edge was designated as a stump negative case. Thirty eight out of 83 1esions (45.7%) were stump negative. In these cases, no residual lesions were found on the follow-up endoscopic examinations or the resected specimen if a gastrostomy was performed thereafter. Thus, a negative stump may indicate that ER can be a curative procedure for early gastric cancer. Analysis of factors which affected negativity of tumor cells at a cutting edge showed that the indications for ER were as follows: lesions less than 10mm in size, lesions without ulcerations, and mucosal lesions in the antrum or at the greater curvature. Five out of six stump positive pabents who subsequently underwent surgery had residual lesions in the resected specimens. Therefore, ER should not be regarded as a curative treatment on a positive stump case.

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