Abstract
A gastric cancer of ha type located in the cardia was resected with an endoscope which was inserted through a specially placed gastrostomy. The patient was a 80-year-old woman. Endoscopic findings showed a ha type gastric tumor at the cardia, and endoscopic biopsy revealed well differentiated adenocarcinoma. Because the patient have respiratory insufficency, a limited operation was desirable, but the lesion was located just beside the cardia and endoscopic mucosal resection (EMR) in the usual manner was thought to be technically impossible. Then percutanous endoscopic gastrostomy was performed with our original method by gastropexy, and an endoscope was inserted through the stoma. The elevated lesion beside the cardia was carefully observed frontally with the endoscope, and EMR was performed with the help of another endoscope which was orally inserted to lift up the lesion. This method enables us to perform EMR even if a lesion is located in the cardia.
