早期胃癌の内視鏡的粘膜切除におけるキャップ吸引粘膜切除法(EMRC法)の有用性について

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タイトル別名
  • The Utility of EMRC(Endoscopic Mucosal Resection Using a Cap-Fitted Panendoscope) as Treatment of Early Gastric Cancer.

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Endoscopic mucosal resection (EMR) is useful as a radical treatment for early gastric cancer. However, a difficulty of this technique depends on the sites of lesions. If the lesions are in the lesser curvature or the posterior wall of the M- or C-region, it is very difficult or even impossible to resect them. We carried out a clinical study to compare the results of EMR using a 2 channel scope (EMR-2CS, conventional method) with those of EMR using a cap-fitted panendoscope (EMRC, newly introduced method) for lesions at the abovementioned sites. Thirty-four patients with 35 lesions (17 lesions resected by EMR-2CS, 18 lesions resected by EMRC) located in the lesser curvature or the posterior wall of the Mor C-region were included in this study, and the results were as follows : 1) Rate of complete resection with EMR-2CS was 64.7% and that with EMRC was 77.8%. 2) Especially, for the lesions located in the lesser curvature or the posterior wall of the M-region, EMRC was very effective and the rate of complete resection reached 90%. On the other hand, the lesions in the lesser curvature or posterior wall of C-region were still difficult to resect even by EMRC, the rate of complete resection being 63%. 3) There were no major complications in EMR-2CS, but there were two patients with massive bleeding and two who suffered from perforation by EMRC. Specimens obtained by EMRC tended to be resected more deeply. Thus we conclude that EMRC is a useful treatment for early gastric cancer located in the lesser curvature or the posterior wall of the M-region.

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