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70´ë Áß¹Ý °ÇÁø ³»½Ã°æ¿¡¼­ °æ°è°¡ ºÒºÐ¸íÇÑ À§¾ÏÀ¸·Î ÀǷڵǾú½À´Ï´Ù. ESD¸¦ ÇÏ¿´´Âµ¥ piecemeal resection µÇ¾ú°í lateral marginÀ» Æò°¡ÇÒ ¼ö ¾ø´Â »óȲÀ̾ú½À´Ï´Ù.

Endoscopic resection of early gastric carcinoma
1. Location : body, posterior wall
2. Gross type : EGC type IIa
3. Histologic type : tubular adenocarcinoma, moderately differentiated >>> tubular adenocarcinoma, poorly differentiated (3 %)
4. Histologic type by Lauren : intestinal
5. Size of carcinoma : (1) longest diameter, 24 mm (2) vertical diameter, 22 mm
6. Depth of invasion : invades mucosa (lamina propria) (pT1a)
7. Resection margin : (1) involved anterior and posterior resection margins, (2) proximal and distal resection margins cannot be determined due to piecemeal resection
8. Lymphatic invasion : not identified(N)
9. Venous invasion : not identified(N)
10. Perineural invasion : not identified(N)
11. Microscopic ulcer : absent
12. Histologic heterogeneity: present

¿¬¼¼, 24 mm lamina propria ¾ÏÀ̾ú´Ù´Â Á¡, À°¾ÈÀûÀ¸·Î´Â residual tumor°¡ ¾ø¾ú´Ù´Â Á¡ µîÀ» °í·ÁÇÏ¿© ¼ö¼ú°ú °æ°ú°üÂûÀÇ Àå´ÜÁ¡À» Àß ¼³¸íÇÑ ÈÄ Åë»ó Àç¹ß·üº¸´Ù ³ôÀ» ¼ö ÀÖÁö¸¸ ÀÏ´Ü ÁÖÀDZí°Ô °æ°ú°üÂûÀ» Çϱâ·Î ÇÏ¿´½À´Ï´Ù. ±×·¯³ª ¾Æ½±°Ôµµ µÎ¹ø° ÃßÀû³»½Ã°æ Á¶Á÷°Ë»ç¿¡¼­ ¾ÏÀ¸·Î È®ÀÎÇÏ¿© subtotal gastrectomy¸¦ ÇÒ ¼ö ¹Û¿¡ ¾ø¾ú½À´Ï´Ù.

µÎ¹ø° ÃßÀû³»½Ã°æ. ¾ÏÀ¸·Î È®ÀεÊ.

Stomach, subtotal gastrectomy:
Early gastric carcinoma
1. Location : middle third, Center at angle and posterior wall
2. Gross type : EGC type IIc
3. Histologic type : tubular adenocarcinoma, moderately differentiated > tubular adenocarcinoma, poorly differentiated (30 %)
4. Histologic type by Lauren : intestinal
5. Size : 3x1.7 cm
6. Depth of invasion : invades mucosa (muscularis mucosae) (pT1a)
7. Resection margin: free from carcinoma
8. Lymph node metastasis : no metastasis in 34 regional lymph nodes (pN0)
9. Lymphatic invasion : not identified
10. Venous invasion : not identified
11. Perineural invasion : not identified
12. Peritoneal cytology : negative
13. AJCC stage by 7th edition: T1a, N0

Laterl margin involvementÀÇ Áß¿ä ¿øÀÎ Áß Çϳª°¡ histological heterogeneityÀÔ´Ï´Ù. ¼ø¼öÇÑ °Íº¸´Ù ¼¯ÀÎ °ÍÀÌ ³ª»Þ´Ï´Ù. Àû¾îµµ ESD ¿µ¿ª¿¡¼­´Â...

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