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Laparoscopic Gastrectomy for Early Gastric Cancer after Endoscopic Mucosal Resection
Authors:Norio SHIRAISHI  Yoshiaki HAGINO  Kazuhiro YASUDA  Toshio Bandoh  Yosuke ADACHI  Seigo KITANO
Abstract:Abstract: In 1991, we first performed a simple technique of Iaparoscopy-assisted Bill-roth I gastrectomy for patients with mucosal gastric cancer. Endoscopic mucosal resection (EMR) sometimes fails to completely resect the early gastric cancer lesion, nor does it give full histopathology of the resected stomach. The aim of this study was to review the surgical and pathological findings of eight patients who underwent laparoscopic gastrectomy after EMR for early gastric cancer. Of 54 patients with early gastric cancer who were treated with laparoscopic gastrectomy between 1994 and 1998, eight patients underwent surgery after EMR. The resected margin of the EMR specimens was positive in three and suspicious in five; and three underwent laparoscopic wedge resection of the stomach, while five underwent Iaparoscopy-assisted distal gastrectomy with regional lymph node dissection. All but one resected stomach had residual cancer tissue in the mucosa or submucosa, and three patients had multiple gastric cancers. The results indicated that remnant cancer tissue might be present when the resected margin of the EMR specimen was positive or suspicious. Partial resection or distal gastrectomy under laparoscopy is useful for such patients who have undergone EMR for early gastric cancer. (Dig Endooc 1999; 11:132–136)
Keywords:stomach  cancer  early gastric cancer  endoscopic mucosal resection (EMR)  laparoscopic gastrectomy
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