Endoscopic treatment of precanceroses and early gastric carcinoma

A plea is made for individual age-adjusted endoscopic therapy of precancerous lesions and, under certain conditions, of early gastric carcinoma. True adenoma and borderline lesion have to be resected, if technically feasible, by snare ectomy. Tumour remnants or local recurrences can be destroyed by argon laser application. In poor-risk patients with a well-differentiated mucosal carcinoma situated close to the cardia, the risk of dying from metastases left behind after endoscopic resection seems less than that of fundectoma or gastrectomy. Endoscopic polypectomy was successfully practised in 6 patients with early gastric carcinoma with no tumor recurrence.