EndoTODAY 내시경 교실
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[Gastric cancer 472]
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ESD 후 수술이 필요하다는 결과입니다.
Stomach, endoscopic submucosal dissection:
Early gastric carcinoma
1. Location : antrum, anterior wall
2. Gross type : EGC type I
3. Histologic type : tubular adenocarcinoma, moderately differentiated >> tubular adenocarcinoma, poorly differentiated (about 5%)
4. Histologic type by Lauren : intestinal
5. Size of carcinoma : (1) longest diameter, 32 mm (2) vertical diameter, 15 mm
6. Depth of invasion : invades submucosa, (depth of sm invasion : 500 ㎛) (pT1b)
7. Resection margin : free from carcinoma(N), safety margin : distal 12 mm, proximal 12 mm, anterior 12 mm, posterior 12 mm, deep 300 ㎛ (sm only)
8. Lymphatic invasion : present (++)
9. Venous invasion : not identified(N)
10. Perineural invasion : not identified(N)
11. Microscopic ulcer : absent
12. Histologic heterogeneity: present
80대 어르신이십니다. 환자는 수술을 받고 싶지 않다고 주장하십니다. 얼마나 강하게 수술을 권해야 할까요? 고민은 끝도 없습니다.
© 일원내시경교실 바른내시경연구소 이준행. EndoTODAY Endoscopy Learning Center. Lee Jun Haeng.