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Review
. 2016 Apr 6:1:24.
doi: 10.21037/tgh.2016.03.22. eCollection 2016.

Endoscopic resection of early gastric cancer: current status and new approaches

Weon Jin Ko  1 , Ga Won Song  1 , Won Hee Kim  1 , Sung Pyo Hong  1 , Joo Young Cho  1
Affiliations
Review

Endoscopic resection of early gastric cancer: current status and new approaches

Weon Jin Ko et al. Transl Gastroenterol Hepatol. .

Abstract

Endoscopic resection (ER) of early gastric cancer (EGC) has been an optimal treatment for selected patients. As endoscopic submucosal dissection (ESD) has been widely used for treatment of EGC, concerns have been asked to achieve curative resection for EGC while guaranteeing precise prediction of lymph node metastasis (LNM). Moreover, a new microscopic imaging for precise endoscopic diagnosis of EGC is introduced. This review covers the current status and new approaches of ER of EGC.

Keywords: Endoscopic resection (ER); confocal laser endomicroscopy; early gastric cancer (EGC); sentinel node navigation.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Features of confocal endomicroscopy. (A) Dysplasia, dark epithelium with irregular and varying thickness is observed; (B) differentiated adenocarcinoma, disorganized epithelium with dark and irregular glands is observed; (C) undifferentiated adenocarcinoma, dark and irregular cells with no identifiable glandular structures are observed. (H&E, ×100).
Figure 2
Figure 2
Endoscopic submucosal dissection with sentinel node navigation. (A) Marking for endoscopic submucosal dissection is performed around the tumor; (B) indocyanine green is injected into the submucosal layer around the tumor for sentinel node navigation; (C) sentinel node harvest is performed by laparoscopic pick-up biopsy; (D) endoscopic submucosal dissection is performed.
Figure 3
Figure 3
Endoscopic full-thickness gastric resection. (A) An elevated lesion is noted at the lesser curvature of upper body; (B) the lesion becomes distinct by chromoendoscopy using acetic acid and indigo carmine; (C) for sentinel node navigation, indocyanine green is injected into the submucosal layer after marking around the tumor; (D) endoscopic full-thickness resection is performed after sentinel node harvest and regional lymph node dissection; (E) final resection is performed with laparoscopy; (F) gastric closure is achieved with laparoscopy; (G) resected specimen; (H) resected lymph node.
See this image and copyright information in PMC

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