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早期胃癌に対する内視鏡的治療においては,一部の症例に残存再発病変の発生がみられ,また異時性多発病変の可能性が無視できない.一方において,適応拡大は可能なのかという点が,早期胃癌に対する内視鏡的治療において問題点として指摘されている.そのため,腹腔鏡下胃切除術が試みられている施設もある.しかし,これらの問題点は内視鏡的治療で安全にかつ確実に処理できるため,敢えて侵襲の強い腹腔鏡下胃切除術を選択する必要性は現在のところない.
The following points are the deficits of endoscopic therapy for early gastric cancer. One point is that some cases are resected serial multiple strip biopsy because the lesion is not completely resected by the first resection. Because of this some residual lesion may occur in these cases. The second point is metachronous lesions are found after the first lesion is completely cured by endoscopic therapy. The third point is there are the possibility to expand the indication of local therapy for early gastric cancer. So wide resection is needed for these lesions.
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