Large Early Gastric Cancers Treated by
Endoscopic Submucosal Dissection with an
Insulation-tipped Diathermic Knife
方嘉郎
Chang CC;Cheng T;Fang CL;Pan S;Liu JD;Lou
HY;Hsieh CJ;Chen SH
摘要
Abstract
It is difficult to remove a large early gastric cancer (≥ 3 cm) in one-piece resection using conventional endoscopic mucosal resection. We tried to use an insulation-tipped (IT) diathermic knife to dissect these lesions. IT-endoscopic submucosal dissection (ESD) was performed in four aging patients with gastric malignancy. All lesions could be removed in one-piece resection by IT-ESD, although three of them exhibited remarkable fibrosis and ulceration. Three cases experienced curative treatment with IT-ESD after the pathologic evaluation, but it was not curative in one case because the pathology showed
angiolymphatic invasion. This patient refused additional surgery in consideration of existing major systemic diseases. At 3 months to 1 year of follow-up, endoscopy showed no evidence of residual cancer. IT-ESD is effective in the treatment of large early gastric cancer and is an alternative treatment for early gastric cancer patients who are at risk for major operation.