内镜粘膜切除术切除胃内早期恶性病变

ENDOSCOPIC MUCOSECTOMY FOR RESECTION OF EARLY GASTRIC CANCER AND PRECAN- CEROUS LESIONS

自１９９１年３月至１９９４年９月，应用内镜粘膜切除术切除胃内早期恶性病变１４例，其中早期粘膜层胃癌６例：ＩＩｃ型４例ＩＩａ型２例；扁平隆起型重度异型增生３例；山田Ｉ型腺瘤５例。所有病变最大直径均小于２０ｍｍ。一次操作病变完全切除１０例，经第二次操作又完全切除２例；不完全切除及残留切除各１例，均行外科手术切除。现已追踪４～４１个月，未见局部复发征象。

he authors collected 14 cases of early gastric cancer located in the mucosa and precancerous lesions which were resected with endoscopic mucosectomy. These lesions were as follows:6 cases were early can- cer(IIc type:4 cases;IIa type:2 cases);3 cases were severe dysplasia;5 cases were adenoma,Yamada I type. The size of all the lesions was less than 20mm,Four cases of early gastric cancer were resected com- pletely. Two cases were resected incompletely,but radical gastrectomy was performed one month after en- doscopic mucosectomy,All the three cases of sevcre dysplasia had complete resection. But two of them re- ceived resection twice. Five cases of adenoma were also resected completely. The criteria of complete endo- scopic resection were those reported in the Japanese literature. All cases have been followed up for 4～41 months;endoscopic and histological studies showed that there were no residual and recurrent cancer cells.The complete resection rate was 85.7%(12/14).The results suggest that endoscopic mucosectomy can be applied to the patients with early gastric cancer located in the mucosa and precancerous lesions less than 0mm in size, which can be resected completely,This method is safe,entails less complications and is es- pecially suitable for the old and weak patients.