Theme |
Clinical Problems after Gastrectomy |
Title |
ESD for Remnant Gastric Cancer |
Author |
Mikitaka Iguchi |
Second Department of Internal Medicine, Wakayama Medical University |
Author |
Hisanobu Deguchi |
Second Department of Internal Medicine, Wakayama Medical University |
Author |
Hideyuki Tamai |
Second Department of Internal Medicine, Wakayama Medical University |
Author |
Kimihiko Yanaoka |
Second Department of Internal Medicine, Wakayama Medical University |
Author |
Masashi Oka |
Second Department of Internal Medicine, Wakayama Medical University |
Author |
Masao Ichinose |
Second Department of Internal Medicine, Wakayama Medical University |
[ Summary ] |
If remnant gastric cancer is diagnosed and fulfills the criteria for lymph node-negative tumors, it is theoretically resectable with endoscopic modalities. However, it is more difficult to perform endoscopic procedures in remnant stomachs than in the normal early gastric cancer cases because of the fibrosis in the submucosal layer which are located on the suture line or because of limitations on endoscopic manipulation. Consequently, total gastrectomies have been performed for a great deal of time. ESD is a practical technique developed to perform en-bloc resection even for gastric cancer in remnant stomachs. However, the level of difficulty is much higher for this procedure than for normal ESD. Therefore, we recommend that ESD for remnant gastric cancer should be performed after acquiring sufficient ability to perform normal ESD. |