早期の残胃癌の特徴―診断のポイント―内視鏡

Endoscopic Diagnosis of Early Gastric Remnant Cancer after Gastrectomy for Gastric Cancer

要旨　胃癌術後の残胃癌は胃体上部小彎・後壁の分化型，隆起型癌が多い．また，残胃癌も早期発見されれば予後は良い．以上を念頭に置いて，内視鏡的には，丈の低い褪色隆起，あるいはにじみ出し出血を見逃さない注意深い観察が大切である．また，条件が悪いときには病変がマスクされている可能性を考慮して，積極的に再検を勧めるべきである．

　Gastric remnant cancers after gastrectomy manifest frequently as elevated lesions and well-differentiated carcinomas often located in the posterior wall or in the lesser curvature of the upper gastric body. Prognosis is generally good if discovered at the early stage. On endoscopic examination, it is necessary to identify slightly elevated discolored lesions or oozy bleeding as these are often features of carcinoma. In cases in which suspect lesions are found, careful exploration and further examination are essential to identify masked or latent lesions.

　1) Digestive Endoscopy Center, Sendai Kousei Hospital, Sendai, Japan