The Study of Endoscopic Mucosal Resection on Gastric Adenoma and Early Gastric Cancer: The Factors Affecting Complete Resection Rate of EMR and Histological Discrepancy between the Endoscopic Biopsy and the Resected Specimen / 대한소화기내시경학회지

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.