ESD for expanded indication cases. EndoTODAY 이준행

[Gastric cancer 841. ESD for an expanded indication case]

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A elderly patient with a neurologic disease visited my clinic for the endoscopic treatment of 4cm sized ill-defined early gastric cancer (histology: M/D). .

I explained very carefully about the pros and cons of ESD for an expanded indication cases, and answered all the questions from the patient and the family members. It took a long time.

ESD was done.

ESD: Early gastric carcinoma
1. Location : antrum, lesser curvature
2. Gross type : EGC type IIc
3. Histologic type : tubular adenocarcinoma, well differentiated
4. Histologic type by Lauren : intestinal
5. Size of carcinoma : (1) longest diameter, 38 mm (2) vertical diameter, 24 mm
6. Depth of invasion : invades mucosa (lamina propria) (pT1a)
7. Resection margin : free from carcinoma(N), safety margin : distal 10 mm, proximal 8 mm, anterior 12 mm, posterior 8 mm, deep 800 ㎛
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: absent

Informed decision from the patient's part is very important for expanded indication cases.