J.Jpn. Surg. Soc.. 89(11): 1780-1788, 1988
Original article
CLINICOPATHOLOGICAL STUDY FOR EARLY GASTRIC CANCER
-INDICATION OF CONSERVATIVE SURGERY AND RADICAL ENDOSCOPIC TREATMENT FOR EARLY GASTRIC CANCER-
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The First Department of Surgery, Niigata University School of Medicine, Niigata, Japan Atsushi Nashimoto**), Shinsuke Tanaka, Kaoru Miyashita, Koichi Sasaki, Terukazu Muto, Jun Soga*) |
The conservative surgery, that is, subtotal gastrectomy with complete dissection of lymph nodes of group 1 and selective celiac group and partial bursectomy, would be indicated for early gastric cancers located in antrum or corpus. But if the metastasis to the group 2 lymph nodes is suspected during the surgery, it is necessary to dissect lymph nodes en bloc more than group 2. The results, concering the type of early gastric cancer without lymph node metastasis and the indicaton of endoscopic treatment, were as follows;
1. Intramucosal cancer of elevated type less than 2cm in diameter.
2. Intramucosal cancer of depressed type less than 1cm in diameter, without peptic ulcer within the lesion, and a differentiated tubular adenocarcinoma histologically.
3. Intramucosal cancer of flat type less than 2cm in diameter.
But it is difficult to detect the depth of cancer invasion and lymph node metastasis preoperatively. We would emphasize that endoscopic treatment should be indicated in the case for which surgical treatment is not indicated.
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