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Korean J Gastrointest Endosc > Volume 40(2); 2010 > Article
Korean Journal of Gastrointestinal Endoscopy 2010;40(2): 90-96.
조기위암에서 내시경점막하박리술 후 진단 및 치료로의 복강경 림프절 절제술의 유용성
김용현ㆍ조주영ㆍ조원영ㆍ조영관ㆍ이태희ㆍ김현건ㆍ김진오ㆍ이준성ㆍ김용진*ㆍ진소영
순천향대학교 의과대학 내과학교실, 소화기병센터, *외과학교실, 임상병리학교실
The Efficacy of Diagnostic and Therapeutic Laparoscopic Lymph Node Dissection after Endoscopic Submucosal Dissection in Early Gastric Cancer
Yong Hun Kim, M.D., Joo Young Cho, M.D., Won Young Cho, M.D., Young Kwan Cho, M.D., Tae Hee Lee, M.D., Hyun Gun Kim, M.D., Jin Oh Kim, M.D., Joon Seong Lee, M.D., Yong Jin Kim, M.D.* and So Young Jin, M.D.
Departments of Internal Medicine, *Surgery and Pathology, Institute for Digestive Research, Soonchunhyang University College of Medicine, Seoul, Korea
Abstract

Background/Aims:
Lymph node metastasis is infrequently found in patients with early gastric cancer (EGC) following surgery. Accurate evaluation of lymph node status is very important in determining the appropriate treatment for patients with EGC. The efficacy of diagnostic and therapeutic laparoscopic lymph node dissection after endoscopic submucosal dissection in patients with EGC at high risk for lymph node metastasis was evaluated.
Methods:
Among patients with EGC who underwent endoscopic submucosal dissection between November 2006 and February 2009, 9 patients with undifferentiated adenocarcinoma, submucosal cancer, immunohistochemically-positive cytoplasmic staining for vascular endothelial growth factor, lymphovascular invasion, a high lymphatic microvessel density, or high microvessel density were selected. All patients underwent laparoscopic lymph node dissection for determination of lymph node status. The local IRB approved the study.
Results:
All of the dissected lymph nodes were free of cancer cells in all of the patients. During 16 months of follow-up, no patients had evidence of tumor recurrence.
Conclusions:
Laparoscopic lymph node dissection after endoscopic submucosal dissection is useful to assess lymph node status and may help guide further treatment for patients with EGC at high risk for lymph node metastasis. (Korean J Gastrointest Endosc 2010;40:90-96)
Key Words: Stomach neoplasm, Lymph nodes, Gastroscopic surgery, Laparoscopic surgery, Immunohistochemistry
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