What Is The Endoscopic Treatment Of Gastric Cancer?

(1) Mucosal resection. Since it was first reported in Japan in 1984, more than 3,000 cases have been reported in Japan by the end of 1995. An appropriate amount of normal saline was injected into the bottom of the cancer focus to make the lesion bulge, and then electrocoagulation resection was performed. Indications were generally early gastric cancer or intramucosal carcinoma with lesion diameter < 2cm; No lymph node metastasis; Non-ulcerative lesions. Because the depth of invasion cannot be determined before ulcerative lesions, type III early gastric cancer is not suitable for this treatment. 113 patients with early gastric cancer who received this treatment were followed up for more than 5 years, and no recurrence was observed. Compared with 33 patients who received surgical treatment during the same period, the efficacy of both patients was similar. Therefore, this method makes it possible to cure early gastric cancer by non-surgical method, and has the advantages of less trauma to human body, wide indications, less complications such as perforation, and low cost.

(2) Laser therapy. Laser irradiation can make living tissue evaporation, solidification and protein denaturation, high power laser can also make living tissue carbonization. Commonly used YAG laser, the laser power is high, fast irradiation effect is good. The absolute indications were uplifted and highly differentiated intramucosal carcinoma with lesion diameter < 2cm and non-ulcerative concave carcinoma with lesion diameter < 1cm, in addition to the relative indications.

(3) Microwave therapy. Microwave frequencies are intermediate between high frequency electricity and laser. High frequency electric coagulation and laser photocoagulation heat energy is external heating, microwave is a kind of internal heating with the organism itself as the heat source, also known as medium heating. Microwave has the coagulation effect of non-carbonizing tissue, which makes tumor necrosis atrophy. The absolute indication was non-ulcerative differentiated adenocarcinoma ≤2cm and intramucosal carcinoma, while the relative indication was low-differentiated adenocarcinoma > 2cm and infiltration into mucous muscle layer.

(4) Alcohol injection therapy. The needle was inserted endoscopically, and 95% alcohol was injected at 4 ~ 8 points, about 0.5ml at each point. This method is ideal for mucosal carcinoma with lesion diameter < 4cm, especially for small gastric cancer and micro gastric cancer. About 50% of the cases have reduced lesion size, limitation and fibrosis after treatment, and follow-up biopsy is consistently negative.

In addition, in recent years, Japan and other countries began to study the laparoscopic and endoscopic treatment of gastric cancer combined with laparoscopy. Methods: laparoscopic wedge-shaped resection of the stomach; Laparoscopic gastric mucosa resection; Laparoscopic R2 gastrectomy. Laparoscopic surgery has the advantages of small damage and low complication rate, but it has the disadvantages of easy to cause tumor intraperitoneal implantation.

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