ENDOSCOPIC SUBMUCOSAL DISSECTION FOR EARLY REMNANT GASTRIC CANCER

概要

論文の詳細を見る
Endoscopic submucosal dissection (ESD) is currently widely accepted as a standard therapy for early gastric cancer with a low risk of lymph node metastasis. Early gastric cancer in the remnant stomach could be also treated with ESD based on its absolute indication and extended indication criteria. ESD provides a minimally invasive procedure and better patient's postoperative quality of life compared with surgical total gastrectomy as a standard therapy for early remnant gastric cancer. However, ESD for gastric cancer in the remnant stomach is technically difficult and is associated with a higher risk of complications than in intact stomach. For example, the decrease of peristalsis in the remnant stomach results in the delay of emptying food and fluids, which can be an obstacle to precise observation. In addition, Lumen in remnant stomach is transformed and narrow. Operation scar and the staples on the suture line and anastomosis exist around the lesion. Those specific matters associated with the remnant stomach make ESD procedures much more difficult. Besides it should be recognized that the positional relationships between the mucosa, muscularis and staples are different whether everting sutures (with or without serosa muscularis suture) or inverting sutures are applied. Since the ideal depth for submucosal dissection varies in each case, it must be decided taking safety and radical cure into consideration. ESD of the remnant stomach should be performed carefully by well-experienced endoscopists, and follow-up after the treatment must be conducted strictly.

ENDOSCOPIC SUBMUCOSAL DISSECTION FOR EARLY REMNANT GASTRIC CANCER

スポンサーリンク

概要

著者

関連論文

スポンサーリンク