Modern treatment of early XXXX : review of the Japanese experience.

@entity1 @entity1697 @entity5 @entity3 @entity158 @entity356
BACKGROUND: Recently, detections of early @entity356 (EGC) have been increasing, and the treatment strategies for @entity356 have been changing. To demonstrate recent clinical experience of EGC in Japan and to assess modern strategies for the treatment of EGC, we investigated the English-language literature of the past 10 years through computer searches. METHODS: This article intends to provide gastric surgeons with recent Japanese experience of the treatment for EGC. In a search for modern treatments of EGC, we selected 100 papers published in well-known medical journals, and focused on the following items of EGC: (1) prognostic factors, (2) endoscopic treatment, (3) surgical procedures, and (4) Japanese guidelines. RESULTS: The most important factor influencing the survival of @entity1 with EGC is the status of lymph node @entity3 . The incidence of lymph node @entity3 is 1-3% for @entity1697 and 11-20% for @entity5 . Endoscopic mucosal resection (EMR) is a technique for the treatment of EGC, and the recent indication includes the @entity5 confined to the mucosa up to 3 cm in size or those invading the superficial submucosa. Surgical procedures include conventional Billroth I gastrectomy, limited resections, and laparoscopic surgery. Laparoscopic wedge resection using the lesion-lifting method and laparoscopy-assisted distal gastrectomy provide less @entity158 , faster recovery and shorter hospital stay. Guidelines for the treatment of @entity356 proposed by the Japanese @entity356 Association show that @entity1 with @entity1697 can be managed by EMR or distal gastrectomy, whereas @entity1 with @entity5 are candidates for distal gastrectomy with lymph node dissection. CONCLUSION: Although the prognosis of @entity1 with EGC depends on the presence or absence of lymph node @entity3 , most are successfully treated by modern endoscopic or surgical techniques. Laparoscopic surgery and limited resections will contribute to the better quality of life of @entity1 with EGC.
