Local Resection of the Stomach Applied with Endoscopic Resection for Early Gastric Cancer -A Point of Contact between Endoscopic Treatment and Limited Surgery-

Kunio Takagi, Keizi Iwakiri, Seizo Takenaga, Shuichi Hayashi

Hayashi Surgical Hospital

The choice of treatment of early gastric cancer (ECG), depending on the staging of cancer, has been changed recently. We present a new procedure for local resection of the stomach, with removal of neighboring lymph nodes, based on the determination of mucosal spread by endoscopic black ink injection with biopsy and diagnosis of the depth invasion by ER. The indication for this procedure is type IIa and IIc EGC of 2-3 cm in size. Local resection was performed in seven patients who showed mucosal and minimal submucosal invasion histologically by ER. All cases showed a negative cut edge and no lymph node metastasis. This procedure is safe based on the histological findings. Distal gastrectomy was performed in three patients who showed moderate submucoal invasion by ER. In three patients with residual cancer after ER, local resection was performed instead of distal gastrectomy. The indications for treatment of EGC, based on the diagnosis of histological depth of invasion by ER, will provide a point of contact between ER and limited surgery.

Key words
early gastric cancer, endoscopic resection, local resection of the stomach

Reprint requests
Kunio Takagi Hayashi Surgical Hospital
27 Daikyocho, Shinjuku-ku, Tokyo, 160 JAPAN

Accepted
June 14, 1993

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