Intragastric endoscopic mucosal resection through a temporary gastrostomy for early gastric cancer: Usefulness of buess-type endoscope

Abstract

Objective: To assess the feasibility of cure of early gastric cancer by the endoscopic procedure done through a temporary gastrostomy and to use it to treat patients with various severe complications. Design: Prospective study. Setting: University hospital, Japan. Subjects: Four patients who required gastric mucosal resection for early gastric cancer. Main outcome measures: Ease of the procedure, cure rate, safety under epidural anaesthesia, and outcome. Results: All patients had the procedure under epidural anaesthesia without pain or complaints during operation. Mean operation time was 120 minutes (60-200). Histological examination showed that the surgical margin was free of tumour in 3 of the cases. One patient who had microscopic invasion of lymph nodes subsequently underwent second-look conventional gastrectomy with lymphadenectomy. Postoperative recovery was rapid, and all patients were discharged from the hospital uneventfully. Conclusion: This organ-preserving procedure enables good visualisation of the tumour and is useful even for high-risk patients.