ヒートプローブによる早期胃癌の内視鏡的治療―その特性と適応

Endoscopic Treatment of Early Gastric Cancer with Heat Probe Method: Its Characteristics and Indications for Treatment

要旨　ヒートプローブによる内視鏡的焼灼法を用いて早期胃癌13症例14病変に対して治療を施行した．治療効果は14例中12例（85.7％）に得られ，経過観察期間は2か月から60か月であった．深達度mでは12例中11例（91.7％）に，腫瘍長径20mm以内では11例中10例（91.0％）に治療効果が得られた．小彎，後壁病変では9例中7例（77.8％）に治療効果が得られ，腎不全，肝硬変などの合併例を含め全例安全に治療できた．本法は操作性，安全性に優れた内視鏡的治療法であると評価できた．本法の根治療法としての適応はリンパ節転移のないm癌に対してであるが，high risk患者や内視鏡的切除が困難な病変に対して，本法は特に有用であると考えられた．

　Endoscopic cauterization with a heat probe was applied to 14 early gastric cancer lesions in 13 patients. It was effective in 12 lesions out of 14 (85.7%). The postprocedure observation period was from 2 to 60 months. Efficacy of this method in the various conditions was as follows; mucosal lesions: 91.7% (11 lesions), less than 20 mm in size: 91% (10 lesions), location on the posterlor or lesser curvature: 77.8% (7 lesions), This procedure could be performed safely in all patients including those with renal failure and liver cirrhosis.

　In conclusion, a heat probe method was useful as an easy and safe procedure. Curable lesions are mucosal cancers without lymph node metastasis. This method is especially valuable for high risk patients and for lesions of which endoscopic resection is difficult.