Abstract
After the introduction of f iberoptic endoscopy and its fully accepted use as an instrument of great diagnostic ability, we are now in an era where the same instrument is providing us with a route for a mode of therapy. The electrosurgical removal of polypoid lesions from the upper gastrointestinal tract with the fiberoptic endoscope has proven to be a safe and effective procedure. Since May 1976, we have experienced more than 150 cases of endoscopical gastric poly-pectomies, and among them the same procedure was performed on a polypoid mucosal cancer, which we classify as an early gastric cancer type IIa. A 79 year old man visited our hospital, and was diagnosed to have a polypoid cancer of 14 mm in diameter at the antrum. He refused to be treated surgically, but was very eager to be treated by removing the lesion endoscopically. The 1st endoscopic polypectomy was performed on Feb. 1977, however, a small piece of cancerous lesion was left on his stomach unfortunately. One year and 3 months after the 1st polypectomy, the same-sized polypoid cancer appeared on the center of the converging folds. Then, the second endoscopic polypectomy was performed on May 1978. The procedure was satisfactory, and the whole polyp-oid cancer was removed with the surrounding mucosa. Histologically, the cancer was well differentiated adenocarcinoma, and there were neither lymphangious nor venous inf iltrations. The patient recovered uneventfully. When a polypoid cancerous lesion is suspected to be limitted within the mucosal layer and less than 15 mm in size, the authors of this paper would like to recommend the endos-copical electrosurgical snaring removal of the lesion. Of course, the careful follow-up study including endoscopical biopsy must be followed.
