Argon plasma coagulation for the treatment of early gastric cancer.
Argon plasma coagulation for the treatment of early gastric cancer.
复制标题
氩离子凝固治疗早期胃癌。
作者：
M. Murakami;Keiitirou Nishino;Ai Inoue;Youko Takaoka;K. Iwamasa;B. Murakami;S. Tanabe
背景/目的
内镜下黏膜切除术（EMR）被广泛用于治疗早期胃癌，被认为是安全有效的。但其适应症范围有限。对于有手术风险的患者，需要其他内镜治疗选择。本研究的目的是评价氩离子凝固术（APC）治疗早期胃癌的安全性和有效性。
方法
对23例早期胃癌患者（平均年龄77.5岁）进行了APC。肿瘤浸润深度，估计主要是通过超声内镜，粘膜在19例和4粘膜下。4例不适合EMR治疗，14例单纯EMR治疗无效。所有患者均随访超过12个月（中位数，42.0 +/-20.8个月）。
结果
15例患者无复发，均存活。4例患者无复发，但死于胃癌以外的原因。4例患者癌症复发。通过APC重复治疗来控制复发，没有技术问题。无严重并发症发生。
结论
APC对早期胃癌EMR后的随访治疗有一定的参考价值。APC对早期胃癌的根治性治疗也是有效的，特别是在老年患者和禁忌手术干预的患者中。
BACKGROUND/AIMS
Endoscopic mucosal resection (EMR) is widely used to treat early gastric cancer and is considered safe and effective. However, its indication range is limited. Other endoscopic treatment options are needed for patients with surgical risks. The aim of the study was to evaluate the safety and effectiveness of argon plasma coagulation (APC) for the treatment of early gastric cancer.
METHODOLOGY
APC was done in 23 patients (mean age, 77.5 years) with early gastric cancer. The depth of tumor invasion, estimated primarily by endoscopic ultrasonography, was mucosal in 19 patients and submucosal in 4. EMR was not indicated in 4 cases, and 14 cases were not successfully treated by EMR alone. All patients were followed up for more than 12 months (median, 42.0+/-20.8 months).
RESULTS
Fifteen patients had no recurrence and survived. Four patients had no recurrence, but died of causes other than gastric cancer. Cancer recurred in four patients. Recurrence was managed by repeated treatment with APC, with no technical problems. No serious complications occurred.
CONCLUSIONS
APC is useful for follow-up treatment of early gastric cancer after EMR. APC may also be effective for radical treatment of early gastric cancer, especially in elderly patients and patients in whom surgical intervention is contraindicated.