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KMID : 0359019960160010015
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Korean Journal of Gastrointestinal Endoscopy
1996 Volume.16 No. 1 p.15 ~ p.24
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Clinicopathologic Evaluation of Endoscopic Mucosal Resection of Early Gastric Carcinomas and Gastric Adenomas
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최명규
박수헌/방춘상/채현석/한석원/최규용/정인식/정규원/선희식
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Abstract
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The endoscopic mucosal resection is a useful method of both accurate diagnosis and treatment of gastric mucosal lesion and has been accepted as a standard procedure of early gastric cancer. Over the 3 year period from 1992 to 1994, 57adenomas and
10
early gastric carcinomas were resected endoscopically at the St. Mary's hospital of Catholic University Medical College. The purpose of this study was to clarify the technical limitations of endoscopic mucosal resection with respect to size
location,
methods.
@ES The results were as follows:
@EN 1) The rate of complete resection on gastric adenoma and EGC was 91.1% and the rate of complete resection at first attempt was 62.7%.
2) 8 lesions of 10 early gastric cancer were resected completely. Those were 2 IIa, 1 IIb and 5 IIc lesions without ulcer.
3) Focal cancer as a consequence of malignant transformation of adenoma was detected in 4 cases (8.2%) after complete mucosal resection.
4) The rate of complete resection was highest at lesions of greater curve of antrum. Incomplete resection and piecemeal resectio rate was higher for lesions of anterior and posterior wall of body than others. Although complete resection of the
lesion
at first attempt is the ideal procedure, 79.2% of lesions less than 1 cm in diameter, 62.2% of those less than 2 cm, and 0% of those larger than 2 cm were completely resected in single step.
5) 7 of 9 lesions were completely resected by the modified mucosal resection technique using transparent cap. It allows more precise targeting and resection of lesions in the post wall of the body which couldn't be observed en face by
panendoscope, but
it has a limitation on lesion with larger size.
The size and the location affected curative endoscopic therapy of gastric neoplasms. For successful endoscopic gastric resection, understanding of the limitations of the procedure are necessary and modified mucosal resection technique using
transparent
cap might be useful in difficult lesions. (Kor J Gastrointest Endosc 16:15~24, 1996)
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KEYWORD
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