ENDOSCOPIC ASPIRATION MUCOSECTOMY AS CURATIVE ENDOSCOPIC SURGERY - ANALYSIS OF 24 CASES OF EARLY GASTRIC-CANCER

The use of endoscopic mucosal resection (EMR) in Japan has increased rapidly in the past decade. It has become a routine procedure for the diagnosis and cure of diseases of the gastrointestinal tract. Several different procedures for EMR have been reported and their usefulness is well established.(1-6) The ''strip biopsy'' method has become the most popular method in Japan.(2-5) However, it requires a double-channel endoscope, which is difficult to introduce into the esophagus and is hard to manipulate, because of its large diameter. In this method one must use grasping forceps to lift up the tumor, but endoscopists often fail to lift it because the mucosa can be torn when it is pulled by the forceps, especially if the tumor is located parallel to the endoscope. So resection itself is very difficult in such cases. We have recently developed an original method of EMR, endoscopic aspiration mucosectomy (EAM), which can always lift up the lesion by suction regardless of its location and does not injure the mucosal surface. In this article we describe the use of EAM in early gastric cancer and evaluate its clinical usefulness. Our technical terminology follows the general rules for gastric cancer study in Japan.(7)