Author/Editor		Stefanovič, Milan
Title		Endoskopsko ugotavljanje in zdravljenje zgodnjega raka želodca
Translated title		Endoscopic diagnosis and treatment of early gastric cancer
Type		članek
Source		Gastroenterolog
Vol. and No.		Letnik 9, št. 20
Publication year		2005
Volume		str. 63-70
Language		slo
Abstract		Introduction. Standard surgical procedure is the therapy of choice for the treatment of gastric cancer. As a result of advances in the technology and in the use of new diagnostic tools, stomach cancer is increasingly being diagnosed in the earlv stage of development when endoscopic therapy can be suitable alternative to a surgical procedure. Patients and methods. We have retrospectively analyzed gastroscopies performed in the Diagnostic center Bled in the period from 1 March 2003 to 28 February 2005. Stomach carcinoma was found in 51 patients of which 28 were male and 23 were female. To make a decision regarding endoscopic mucosal resection (EMR), we used endoscopic ultrasound (EUS), lesion spraying with indigo carmine 0,2% solution and a magnifying endosoope. EMR of early carcinoma was not performed in cases where the diameter was greater than 10 mm in sessde an d flat lesion or if the base of the pedunculated malignant polyp was greater than 20 mm. EMR was performed in the standard manner with a polypectomy snare ("strip method") or by using a transparent cap ("cap method"). Results. At the DC Bled, we have diagnosed 51 patients with gastric cancer in a two year period. Nine patients had early carcinoma, which we were able to remove using EMR. We have additionally performed EMR on two patients with gastric carcinoid tumor, a patient with isolated gastric NHL (non-Hodgkin s lymphoma) and on 54 patients with benign superficial neoplasm's of the stomach. During this period, we have endoscopically removed malignant and benign neoplasm from 66 patients. One patient required urgent endoscopic intervention and blood transfusion. There were no complications requiring surgical intervention. Conclusion. In some cases, EMR can be successful in treating early gastric cancer. (Abstract truncated at 2000 characters)
Summary		Izhodišča. Klasični kirurški poseg je terapija izbora za zdravljenje karcinoma želodca. Zahvaljujoč napredku na področju tehnologije in uporabi novih diagnostičnih pripomočkov, rak želodca vedno pogosteje ugotavljamo v zgodnji fazi razvoja, ko je endoskopska terapija lahko ustrezna alternativa kirurškemu posegu. Bolniki in metode. Retrospektivno smo analizirali gastroskopije, ki smo jih v Diagnostočnem centru Bled opravili v času od 1. 3. 2003 do 28. 2. 2005. Pri 51 bolnikih, 28 moških in 23 ženskah, je bil ugotovljen karoinom želodca. Za odločitev glede endoskopske mukozne-resekcije (EMR) smo si pomagali z endoskopskim ultrazvokom (EUZ), barvanjem lezij z 0,2% raztopino indigo karmina in uporabo endoskopa s povečavo. EMR zgodnjega karcinoma nismo opravljali, če je bil premer večji kot l0 mm pri sesilnih in plazečih oziroma, če je bila osnova pecljatega malignega polipa večja kot 20 mm. EMR smo opravili na klasični način s polipektomijsko zanko ("strip metoda") ali s pomočjo prozornega nastavka ("cap metoda"). Rezultati. V DC Bled smo v dvoletnem obdobju pri 51 bolnikih ugotovili karcinom želodca. Devet bolnikov je imelo zgodnji karcinom. katerega smo lahko odstranili s pomočjo EMR. Dodatno smo EMR opravili pri dveh bolnikih s karcinoidom želodca, enemu bolniku z NHL (Ne-Hodkinovim limfomom) želodca in pri 54 bolnikih z benignimi površinskimi neoplazmami želodca. V tem času smo po endoskopski poti odstranili maligno ali benigno neoplazmo, pri 66 bolnikih. En bolnik je potreboval urgentno gastroskopijo in transfuzijo krvi. Zapletov, ki bi zahtevali kirurški poseg, ni bilo. (Izvleček skrajšan na 2000 znakov)
Descriptors		STOMACH NEOPLASMS ENDOSONOGRAPHY