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Long-term outcomes of intragastric endoscopic mucosal resection using a modified buess technique for early gastric
T Nakagoe1, K Tanaka, T Yasutake
1First Department of Surgery, Nagasaki University School of Medicine, Nagasaki, Japan. nakagoe@net.nagasaki-u.ac.jp
Background/Aims:
The aim of this study was to clarify long-term outcomes of endoscopic mucosal resection (EMR) using a modified Buess technique for mucosal gastric cancer.
Methods:
The procedure included en bloc mucosal resection using a Buess-type rectoscope into the gastric lumen via a temporary gastrostomy under video camera guidance. We reviewed 5 patients who underwent this procedure between 1995 and 1997 with a single mucosal cancer of the stomach that was unsuitable for en bloc excision by endoscopic snare diathermy.
Results:
All tumors were superficial elevated types (type 0-IIa) located in the middle third and posterior wall of the stomach. Median maximum tumor diameter was 2.2 (range 1.1-3.5) cm. There was no operative mortality. One patient developed a hemorrhagic gastric ulcer postoperatively. All tumors histologically showed curative potential of the mucosal resection without margin involvement. During a median follow-up period of 64 (50-77) months, none of the patients developed local recurrence. One patient had an early gastric cancer that metachronously developed at another stomach site.
Conclusion:
Intragastric EMR using a modified Buess technique appears to be a useful treatment for cure of mucosal gastric cancer for a limited group of patients unsuitable for complete en bloc excision by endoscopic snare diathermy.
