Surgical treatment of early gastric cancer

Surgical treatment of early gastric cancer includes:

(1) Endoscopic mucosal resection (EMR) The prerequisite for this surgery is that there is no metastasis to the perigastric lymph nodes. It is suitable for well-differentiated intramucosal cancer with a diameter of less than 2 cm and no ulceration on the surface of the lesion. It is especially suitable for elderly and frail patients who cannot tolerate or refuse open surgery.

(2) The indications for local gastrectomy are the same as those for endoscopic gastric mucosal resection. It is more suitable for patients who have difficulty with EMR resection or incomplete resection. Dye injection is required to locate the lesion before surgery.

(3) Subtotal gastrectomy: Patients diagnosed with differentiated gastric intramucosal carcinoma (diameter of elevated cancer <4 cm, diameter of depressed or elevated and depressed cancer <2 cm) without ulcers can undergo subtotal gastrectomy and lymph node dissection.

Early gastric cancer that has invaded the submucosal layer has a high rate of lymph node metastasis. Intramucosal cancers with ulceration or scar formation are mostly poorly differentiated cancers. If the diameter is >2.0 cm, it is not appropriate to reduce the scope of surgical resection.