Endoscopic Management of Early Gastric Adenocarcinoma and Preinvasive Gastric Lesions

Surg Clin North Am. 2017 Apr;97(2):371-385. doi: 10.1016/j.suc.2016.11.010.

Abstract

Early gastric cancer (ECG) can be difficult to diagnose endoscopically. Endoscopists should be familiar with subtle changes and endoscopic features of EGC. Chromoendoscopy and image-enhanced endoscopy improve diagnostic accuracy and facilitate endoscopic resection. Endoscopic submucosal dissection is a preferred endoscopic technique for resection of EGC and offers a comparable overall survival to surgical resection. Endoscopic management of benign gastric epithelial polyps (fundic gland polyps, hyperplastic polyps, and gastric adenoma) depends on patient symptomatology, patient's comorbidities (eg, familial syndromes), lesions' characteristics, and risk of malignant transformation. This article provides an overview of endoscopic management of EGC and common premalignant gastric lesions.

Keywords: Detection; Early gastric cancer; Endoscopic submucosal dissection; Gastric cancer; Narrow band imaging; Screening; Stomach neoplasms.

Publication types

  • Review

MeSH terms

  • Adenocarcinoma / diagnosis
  • Adenocarcinoma / surgery*
  • Adenoma / diagnosis
  • Adenoma / surgery
  • Blood Loss, Surgical / statistics & numerical data
  • Coloring Agents
  • Early Detection of Cancer
  • Gastroscopy / adverse effects
  • Gastroscopy / methods*
  • Humans
  • Intestinal Perforation / etiology
  • Intestinal Polyps / diagnosis
  • Intestinal Polyps / surgery
  • Narrow Band Imaging / methods
  • Postoperative Complications / etiology
  • Stomach Neoplasms / diagnosis
  • Stomach Neoplasms / surgery*

Substances

  • Coloring Agents