Korean J Gastrointest Endosc > Volume 34(6); 2007 > Article
Korean Journal of Gastrointestinal Endoscopy 2007;34(6): 291-297.
위선종과 위점막암에서 내시경 점막분할절제술 후 보조적 아르곤플라즈마응고술의 임상 효과
아주대학교 의과대학 소화기내과학교실
The Clinical Effect of Supplementary Argon Plasma Coagulation after Endoscopic Mucosal Piecemeal Resection of a Gastric Adenoma and Carcinoma
Sang Joon Park, M.D., Kee Myung Lee, M.D., Deok Ki Kim, M.D., Sung Jae Sin, M.D., Jae Ho Jung, M.D., Sung Hyeon Jung, M.D., Byeong Moo Yoo, M.D., Ki Baik Hahm, M.D. and Jin Hong Kim, M.D.
Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea

This study was designed to determine the effect of supplementary argon plasma coagulation (APC) after piecemeal resection of a gastric adenoma or an intramucosal adenocarcinoma.
Cases of 62 lesions of 56 consecutive patients with either a gastric adenoma or carcinoma were retrospectively reviewed at the Ajou University Medical Center. APC was performed after an endoscopic complete resection using the piecemeal method of endoscopic mucosal resection (EMR) for patients in the EMR-APC group. For patients in the EMR group, APC was not performed.
There was no significant difference in the recurrence rate of the cancers for both groups (9.7%, for the EMR group, 6.5% for the EMR-APC group). The recurrence rate of a low grade dysplasia was 6.7% (EMR group) and 6.3% (EMR-APC group) (p=1.000), the recurrence rate for a high grade dysplasia was 11.1% (EMR group) and 25.0% (EMR-APC group) (p=1.000), and the recurrence rate for an intramucosal adenocarcinoma was 14.3% (EMR group) and 0% (EMR-APC group) (p=0.389). The recurrence rates of lesions in which the lesion size was less than 20 mm and over 20 mm for each group were 6.7% and 9.1% (EMR group) (p=1.000) versus 12.5% and 0% (EMR-APC group) (p=0.520). There was also no significant statistical difference in the recurrence rates for both groups according to the location and macroscopic type of lesion.
Supplementary treatment with APC could not significantly reduce the recurrence rate after complete piecemeal resection determined macroscopically. A large- scale and prospective study is necessary to elucidate the clinical significance of supplementary APC for gastric neoplasm treatment.
Key Words: Endoscopic mucosal resection, Argon plasma coagulation, Recurrence
주요어: 내시경 점막절제술, 아르곤플라즈마응고술, 재발률
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