Intragastric endoscopic mucosal resection through a temporary gastrostomy for early gastric cancer: Usefulness of Buess-type endoscope

Objective: To assess the feasibility of cure of early gastric cancer by the endoscopic procedure done through a temporary gastrostomy and to use it to treat patients with various severe complications. Design: Prospective study. Setting: University hospital, Japan. Subjects: Four patients who required gastric mucosal resection for early ga stric cancer. Main outcome measures: Ease of the procedure, cure rate, safety under epidu ral anaesthesia, and outcome. Results: ALI patients had the procedure under epidural anaesthesia without pain or complaints during operation. Mean operation time was 120 minutes (6 0-200). Histological examination showed that the surgical margin was free o f tumour in 3 of the cases. One patient who had microscopic invasion of lym ph nodes subsequently underwent second-look conventional,gastrectomy with l ymphadenectomy. Postoperative recovery was rapid, and all patients were dis charged from the hospital uneventfully. Conclusion: This organ-preserving procedure enables good visualisation of t he tumour and is useful even for high-risk patients.