Takekoshi T, Takagi K, Fujii A, Kato Y
Gan No Rinsho. 1986 Aug;32(10):1185-90.
The indication for EDSP was studied in 75 patients with early gastric cancer diagnosed endoscopically which had been obtained over a period of 11 years (1979 to 1985) at the Cancer Institute Hospital, Tokyo and the following results were obtained. EDSP consists of two procedures using double channel fiberscope; a sessile or depressed lesion pulled upward by one snare cautery (standard EDSP) is transformed into a subpedunculated one, which allows another snare cautery of pseudostalk, and it is excised by using coagulation current. EDSP was performed in 53 cases of IIa type and 22 cases of IIc type. Excision by one snare cautery was possible in 90.9% (40/44) of IIa lesion measuring less than 2 cm and in 100% (14/14) of IIc lesion measuring less than 1 cm, the total being 85.3% (64/75). There was no residual cancer in 41 cases of IIa lesion (93.2%) and 17 cases (85.0%) of IIc lesion with two recurrent cancers confirmed by follow-up endoscopy. Residual cancer was found in 6 cases (9.1%) which were operated on. The results mentioned above show the usefulness of EDSP and selection of case without lymph node metastasis permitting complete excision by one snare cautery is of much importance. EDSP is indicated for IIa lesion of differentiated type measuring less than 2 cm, IIc lesion of differentiated type without ulceration measuring less than 1 cm and IIc lesion of undifferentiated type without ulceration measuring less than 0.5 cm that is not located in the fundic gland area.
对东京癌症研究所医院11年（1979年至1985年）期间经内镜诊断的75例早期胃癌患者进行了内镜下黏膜下剥离术（EDSP）指征的研究，结果如下。EDSP由使用双通道纤维内镜的两个步骤组成；通过一个圈套电凝将无蒂或凹陷性病变向上提拉（标准EDSP），使其转变为亚蒂性病变，这样就可以对假蒂进行另一次圈套电凝，然后使用凝固电流将其切除。对53例IIa型和22例IIc型病例进行了EDSP。对于直径小于2 cm的IIa病变，90.9%（40/44）可通过一次圈套电凝切除；对于直径小于1 cm的IIc病变，100%（14/14）可通过一次圈套电凝切除，总体切除率为85.3%（64/75）。随访内镜检查证实，41例IIa病变（93.2%）和17例IIc病变（85.0%）无残留癌。手术的6例（9.1%）发现有残留癌。上述结果表明了EDSP的有效性，选择无淋巴结转移且能通过一次圈套电凝完全切除的病例非常重要。EDSP适用于直径小于2 cm的分化型IIa病变、无溃疡且直径小于1 cm的分化型IIc病变以及无溃疡且直径小于0.5 cm且不在胃底腺区的未分化型IIc病变。
