Abstract
Since the Endoscopic Microwave Coagulation Therapy (EMCT) was considered to be effective as curative treatment of early gastric cancer, this study was carried out. In the fundamental study, the coagulative effect of the ball type electrode which was newly used for early gastric cancer was clarified, and 5 to 10 seconds at 40w in output was concluded to be proper. In 63% of preoperatively coagulated cases whose tumors seemed to be completely coagulated, no malignant finding was seen in the histopathological series and these results suggested that EMCT might effect a radical cure locally. In all the 17 cases which were unable to undergo an operation, malignant findings disappeared after 1 to 5 times of EMCT with an average of 2.3 times. From an analysis of the clinical results, it was suggested that a lesion could be completely cured by only one session of EMCT, if it was within 20 mm in diameter, macroscopically protruded, histologically well differentiated, mucosal in depth and endoscopically at full face. Ultrasonically the coagulated area changed to be hyperechoic immediately after EMCT and was surrounded with a hypoechoic layer one day after, suggesting that EUS might be able to judge the effect of EMCT. It is concluded that EMCT can coagulate lesions successfully and safely by using both needle and ball type electrodes, and that curative treatment of early gastric cancer may be acquired by EMCT under strict indication and accurate judgement of effect.
