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Indication for endoscopic resection for undifferentiated type of minute gastric carcinomas from the aspect of their size

Indication for endoscopic resection for undifferentiated type of minute gastric carcinomas from the aspect of their size

Stomach & Intestine 30(10): 1279-1287

Endoscopic resection (ER) for undifferentiated type carcinomas was considered more dangerous than resection of the differentiated type, because they often had scirrhous invasion even though they are small in size. Nine cases of undifferentiated type of early gastric carcinomas measuring 1 cm or less in size were performed in our department using endoscopic resection. The size of the cancer was diagnosed almost correctly by x-ray and endoscopy before ER but some cases were misdiagnosed because of intramucosal invasion without accompanying depressive changes. Such invasion characterized an undifferentiated carcinoma limited in size to within 2 mm from the margin of its depression. Because of this phenomenon, at the time of ER, it is necessary to resect specimens at least 4 mm larger in size those of carcinomas. We concluded that minute carcinomas of undifferentiated type and less than 5 mm in size might be resected safely if the above mentioned conditions were fulfilled.

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