Abstract

Gastroendoscopy is one of the important examinations of the stomach. There are several kinds of instruments for gastroendoscopy: gastrocamera (Va) is desirable to describe stomach lesions by colorfilm. Fiberscope (SL) is very helpful in directly observating the mucosal response in the stomach. Fibercamera (GTF) has both abilities above mentioned. Fiherscorpe for biopsy (BL) is desirable to obtain biopsy specimen from mass or abnormal mucosa. It is necessary to make correct diagnosis to use several instruments one at the time according to theirr ability. For the purpose of getting the best signs for endoscopic diagnosis, we tried to examine the stomach by two orr three gastroendoscopes, some times 5, serially in one day. Therefore we took the pictures of all over the gastric mucosa first, inspecting by GTF fiber camera and then described it again by Va gastrocamera. Biopsy specimen were also obtained by BL Fiberscope from the portion where some lesions were suspected by GTF fibercamera. One thousand one huedred and eighty four gastroscopies were performed from July 1970 to September 1971 at the Keio University Hospital. We can make correct diagnosis of 1182 gastric lesions by this endoscopic approach, except 2 cases of reticulum cell sarcoma. The ratio of correct diagnosis was very high, calculated as 99.6%. As for the ratio of correct diagnosis, those were 93.8% with a single use of GTF fivercamera, 97.7% with a combined use of GTF fiber camera and Va gastrocamera, and 99.6% when BL fiherscope were additionally used to obtain the biopsies. It might be necessary to use three instruments (fiber camera, gastrocamera and fiherscope for biopsy) without hesitation in order to obtain accurate diagnosis, whenever the lesion is suspicious.