Heo Jun, Jeon Seong Woo
Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
Clin Endosc. 2013 May;46(3):235-8. doi: 10.5946/ce.2013.46.3.235. Epub 2013 May 31.
Nowadays, endoscopic mucosal resection or endoscopic submucosal dissection has shown effectiveness equivalent to that of gastrectomy and has emerged as a popular technique for curative treatment of gastric cancer. However, noncurative resection or resection beyond the indication may lead to lymphatic and extended organ metastasis resulting in loss of the opportunity for full recovery. Therefore, it is an important issue to decide the range of curative resection in the endoscopic resection field. Furthermore, management of noncurative endoscopic resection in early gastric cancer is also important. The most favorable treatment after noncurative resection would be surgery. However, other noninvasive treatments such as argon plasma coagulation, additional endoscopic resection and close observation for recurrence are thought to be the optional treatments after the noncurative resection. In the future, prospective research studies and observations are expected to verify the effectiveness of noninvasive treatments.
如今,内镜黏膜切除术或内镜黏膜下剥离术已显示出与胃切除术相当的疗效,并已成为一种治疗胃癌的常用根治性技术。然而,非根治性切除或超出适应证范围的切除可能导致淋巴转移和远处器官转移,从而失去完全康复的机会。因此,在内镜切除领域确定根治性切除范围是一个重要问题。此外,早期胃癌非根治性内镜切除的处理也很重要。非根治性切除后最理想的治疗方法是手术。然而,其他非侵入性治疗,如氩等离子体凝固、额外的内镜切除和密切观察复发情况,被认为是非根治性切除后的可选治疗方法。未来,前瞻性研究和观察有望验证非侵入性治疗的有效性。