Abstract
Endoscopic mucosal resection (EMR) was developed and widely spread for the treatment of early gastric cancer because of its minimally invasiveness. Otherwise, surgical therapy should be performed if the result of the first EMR is imperfect. To evaluate the feasibility of the whole therapy such as EMR, Laser Irradiation and Endoscopic Surgery, we studied the outcome after those several treatments for early gastric cancer. The EMR was applied for gastric cancer at the mucosal (m) layer or at the superficial submucosal (sm) layer without lymphatic (ly) and venous (v) invasion. The results of EMR would be perfect if no cancer was detected at the vertical and horizontal margins in the surgical specimens after EMR. On the other hand, Laparoscopic assisted gastrectomy was applied for gastric cancer measuring 10 mm or over in diameter, lesions of type IIc, at deep sm layer or deeper location, with lyv invasion, or the resting cancer by histological diagnose after EMR.
We examined 161 early gastric carcinoma cases. 49 cases were followed after EMR, EMR added laser irradiation were 58 cases, 14 cases were followed after simple laser irradiation and surgical gastrectomy were performed 53 cases, including 44 cases of laparoscopic assisted distal gastrectomy and 3 cases of laparoscopic assisted total gastrectomy. No lymphatic metastasis, surgical complications and recurrences after the surgery were observed.
We hope to treat the early gastric cancer completely by series of endoscopic therapeutic way.
