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Korean J Gastrointest Endosc > Volume 28(5); 2004 > Article

Korean Journal of Gastrointestinal Endoscopy 2004;28(5): 223-229.

위선종과 조기위암에서 내시경 점막절제술의 연구-완전절제율에 영향을 미치는 인자와 점막 절제술 전후의 조직학적 차이-

김은순*·이정환·류수형·김유선·문정섭

인제대학교 서울백병원 내과학교실, *서울적십자병원 내과

The Study of Endoscopic Mucosal Resection on Gastric Adenoma and Early Gastric Cancer-The Factors Affecting Complete Resection Rate of EMR and Histological Discrepancybetween the Endoscopic Biopsy and the the Resected Specimen-

Eun Soon Kim, M.D.*, Jung Whan Lee, M.D., Soo Hyung Ryu, M.D., You Sun Kim, M.D.and Jeong Seop Moon, M.D.

Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine,*Department of Internal Medicine, Seoul Red Cross Hospital, Seoul, Korea

Abstract

Background/Aims:
Endoscopic mucosal resection (EMR) has been known as a method of local treatment for early gastric cancer (EGC) or gastric adenoma. The purpose of this study was to identify the factors affecting complete resection rate (CRR) of EMR and to identify histological discrepancy between endoscopic biopsy and the resected specimen obtained by EMR.
Methods:
Forty four gastric adenomas and twenty seven EGCs in 63 patients were treated by EMR from January, 1999 until August, 2002. We analysed the factors affecting CRR on the basis of location, macroscopic type, size, piecemeal resection, and EMR methods.
Results:
The CRR in antrum was 72%. The CRR of the method using endoscopic resection with hypertonic saline-epinephrine solution, injection, precutting and snaring (ER-HSE) was 78%. The CRR according to en bloc resection was 77%. Sixty six percents of histological coincidence was noted between the endoscopic biopsy and the resected specimen of gastric adenoma.
Conclusions:
In this study, the CRR of the ER-HSE method and the lesion located in antrum is higher than that other groups. Gastric adenoma should be removed by EMR because of histologic discrepancy between the endoscopic biopsy and the resected specimen. (Korean J Gastrointest Endosc 2004;28:223- 229)

Key Words: Endoscopic mucosal resection, Early gastric cancer, Gastric adenoma

주요어: 내시경 점막절제술, 조기위암, 위선종