METHODS: We reviewed the records of 203 patients who underwent PG for cT1 gastric cancer between 2006 and 2015. The remnant stomach was categorized as a pseudofornix, corpus, or antrum.
RESULTS: Thirty-two MRGCs were identified in the 29 patients. Twenty MRGCs were classified as ER (ER group, 62.5%), whereas 12 were not (non-ER group, 37.5%). MRGCs were located in the pseudo-fornix in 1, corpus in 5, and antrum in 14 in the ER group, and in the pseudo-fornix in 6, corpus in 4, and antrum in 2 in the non-ER group (P=0.019). Multivariate analysis revealed that the pseudo-fornix was an independent risk factor for non-ER (P=0.014). In the non-ER group, MRGCs at the pseudo-fornix (n=6) had more frequent undifferentiated-type histology (4/6 vs. 0/6), deeper (≥pT1b2; 6/6 vs. 2/6) and nodal metastasis (3/6 vs. 0/6) than non-pseudo-fornix lesions (n=6). We examined the visibility of the region developing MRGC on an annual follow-up endoscopy one year before MRGC detection. In seven lesions at the pseudofornix, visibility was only secured in two (28.6%) because of food residues. Of the 25 lesions in the non-pseudo-fornix, visibility was secured in 21 lesions (84%; P=0.010).
CONCLUSIONS: Endoscopic visibility increases the chances of ER applicability. Special preparation is required to ensure the complete clearance of food residues in the pseudo-fornix.
方法:我们回顾了2006年至2015年间因cT1胃癌而接受PG治疗的203例患者的记录。剩余的胃被归类为假穹窿,语料库,或者胃窦.
结果:在29例患者中发现32例MRGC。20个MRGC被归类为ER(ER组,62.5%),而12个不是(非ER组,37.5%)。在ER组中,MRGC位于1个假穹窿,5个语料库和14个胃窦。在非ER组中,在6个假穹窿中,在4个语料库中,在2个胃窦中(P=0.019)。多因素分析显示,假穹窿是非ER的独立危险因素(P=0.014)。在非ER组中,假穹窿(n=6)的MRGC具有更频繁的未分化型组织学(4/6vs.0/6),更深(≥pT1b2;6/6vs.2/6)和淋巴结转移(3/6vs.0/6)比非假性穹窿病变(n=6)。我们在MRGC检测前一年的年度随访内窥镜检查中检查了发展MRGC的区域的可见性。在假穹窿的七个病变中,由于食物残渣,能见度只有两个(28.6%)。在非假穹窿的25个病变中,在21个病灶中可见性得到了保证(84%;P=0.010).
结论:内窥镜可见性增加了ER适用性的机会。需要特殊的准备,以确保完全清除假穹窿中的食物残渣。