Abstract
The results of nation-wide postal survey which was intended to provide information on experience with endoscopic treatments for tumor of the stomach in Japan are reported. Out of 143 institutions approached, 71 responded. Names of the institutions are listed in Table 18. Endoscopic treatment for early gastric cancer as a local curative procedure was investigated in 1653 patients at 61 institutions. Endoscopic treatment for advanced gastric cancer as a palliative procedure was attempted in 386 patients at 35 institutions. Nagative biopsy was obtained in 83 to 85% of patients with early gastric cancer in which snare ectomy was impractical or even hazardous, treated by laser therapy such as YAG and photodynamic therapy (PDT) and followed up for more than 1 year. Endoscopic double snare polypectomy, electrosurgical methods combined with intramucosal injection of solution such as strip-off biopsy (high frequency electrocurrent with injection of saline) and endoscopic resection with hypertonic saline and epinephrine yielded 97 to 100% of success rate. Tissue coagulation by microwave therapy was also attempted with good results. Effect of local injection of pure ethanol, picibanil (immunotherapeutic agent of streptococcal preparation) and anti-tumor agents were investigated in a small number of patients. Gastric adenomas are also candidate for endoscopic treatment and 945 patients were treated by various methods with good results. Palliative therapy for advanced gastric cancer was attempted for recanalization of malignant stenosis, tumor reduction and hemostasis of hamorrhagic tumor and overall success rates were 43%, 36% and 70%, respectively.
