Endoscopic diagnostics and minimally invasive surgery in the treatment of gastric cancer in the early stages
National Medical Academy of Postgraduate Education named P.L. Shupika, Kiev, Ukraine
An algorithm for diagnosis and treatment of gastric cancer in the early stages is suggested. The findings are shown that obtained on the stages of comprehensive study summarizing the results of endoscopic diagnostics, surgical and minimally invasive treatment of 623 patients with precancerous conditions and stomach cancer in early stages.
According to the study, in the description of semiotics, the general Endoscopic ultrasound (EUS) sign of stomach’s cancer is hypoechoic formation, which is characterized by varying invasion depth, and proceeds from the mucous membrane of the organ.
Index of efficiency of EUS regarding to standard endoscopy in determining the boundaries of the tumor spread is 186 points (P (Ĉ) = (0, 14)), that more efficient by 32%, providing the evidence base to the possibility of minimally invasive radical operation for gastric cancer in its early stages in 30.9% patients.
Endoscopic mucosal resection and submucosal dissection for early gastric cancer have given the identical results in long-term observations as organ-sparing minimally invasive operations, however, laparoscopic segmental and transgastral resection of stomach, unlike endoscopic techniques allowing to remove the pathological focus on all depth of organ’s wall (index of efficiency is 92 points; P (Ĉ) = (0, 18)
Keywords: gastric cancer, premalignant diseases, minimally invasive surgery, endoscopy.
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