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近期在日本发明新型内镜技术,可以切除胃粘膜的息内和扁平病变,用内窥镜技术可能遗留胃周围的阳性淋巴结,降低治愈率。但在无淋巴结侵犯的情况下,内窥镜切除的后果与剖腹根治手术相同。因此,如能预知无淋巴结转移,可应用内窥镜技术。病人和方法 1964～1990年在东京医学院外科共计手术切除748例早期胃癌。667例(91%)行近端胃切除,其余的行全胃切除,其中5例行远端胃切除,分析各种与淋巴结转移有关的因素。全组748例中,77例(10.3%)病理确认为淋巴结
The recent invention of a novel endoscopic technique in Japan can remove intra- and flat lesions of the gastric mucosa. Endoscopic techniques may leave positive lymph nodes around the stomach and reduce the cure rate. However, in the absence of lymph node involvement, the consequences of endoscopic resection are the same as for radical laparotomy. Therefore, endoscopic techniques can be applied if no lymph node metastasis can be predicted. Patients and Methods Totally 748 cases of early gastric cancer were surgically removed from the Tokyo Medical College from 1964 to 1990. Ninety-six patients (91%) underwent proximal gastrectomy, and the remaining underwent total gastrectomy. Five of them underwent distal gastrectomy to analyze various factors associated with lymph node metastasis. Of the 748 patients in the entire group, 77 (10.3%) were pathologically confirmed as lymph nodes.