早期胃癌に吾ける内視鏡レーザーの適応と限界

抄録

The long-term effect of endoscopic laser therapy for early gastric cancer as a local curative procedure was reported Sixty-six patients with endoscopicslly diagnosed early gastric cancer whose surgical risk was critical or who refused surgery were treated by either Nd: YAG laser or photodynamic therapy (PDT) or both. Curative effect of Nd: YAG and PDT was expected in lesions of superficially elevated mucosal cancer less than 20mm and well demarcated superficially depressed mucosal cancer less than 10mm. All the lesions in this category (11 elevated lesions, 13 depressed lesions) were completely eradicated and negative for cancer on follow-up biopsy for more than 12 months. Risks of lymphnode metastasis in these lesions are reportedly minimal as well. Therefore, we conclude that the endoscopic laser is the treatment of choice for early gastric cancer as a local curative procedure in the aged if they have a curable lesions as mentioned above. However, it is so difficult to control the lesions beyond this category that further advances of laser medicine are needed.