title: Long-term outcomes of intragastric endoscopic mucosal resection using a modified buess technique for early gastric cancer.
abstract: OBJECTIVE
  The aim of this study was to clarify long-term outcomes of endoscopic mucosal resection (EMR) using a modified Buess technique for mucosal gastric cancer.
  
  
  METHODS
  The procedure included en bloc mucosal resection using a Buess-type rectoscope into the gastric lumen via a temporary gastrostomy under video camera guidance. We reviewed 5 patients who underwent this procedure between 1995 and 1997 with a single mucosal cancer of the stomach that was unsuitable for en bloc excision by endoscopic snare diathermy.
  
  
  RESULTS
  All tumors were superficial elevated types (type 0-IIa) located in the middle third and posterior wall of the stomach. Median maximum tumor diameter was 2.2 (range 1.1-3.5) cm. There was no operative mortality. One patient developed a hemorrhagic gastric ulcer postoperatively. All tumors histologically showed curative potential of the mucosal resection without margin involvement. During a median follow-up period of 64 (50-77) months, none of the patients developed local recurrence. One patient had an early gastric cancer that metachronously developed at another stomach site.
  
  
  CONCLUSIONS
  Intragastric EMR using a modified Buess technique appears to be a useful treatment for cure of mucosal gastric cancer for a limited group of patients unsuitable for complete en bloc excision by endoscopic snare diathermy.
authors.affiliation: First Department of Surgery, Nagasaki University School of Medicine, Nagasaki, Japan. nakagoe@net.nagasaki-u.ac.jp
authors.forename: T
authors.initials: T
authors.lastname: Nakagoe
authors.forename: K
authors.initials: K
authors.lastname: Tanaka
authors.forename: T
authors.initials: T
authors.lastname: Yasutake
authors.forename: T
authors.initials: T
authors.lastname: Sawai
authors.forename: T
authors.initials: T
authors.lastname: Tsuji
authors.forename: A
authors.initials: A
authors.lastname: Nanashima
authors.forename: S-I
authors.initials: SI
authors.lastname: Shibasaki
authors.forename: H
authors.initials: H
authors.lastname: Yamaguchi
authors.forename: H
authors.initials: H
authors.lastname: Ayabe
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005753:Gastric Mucosa / Q000473:pathology / Q000601:surgery*; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D012189:Retrospective Studies; D018570:Risk Assessment; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome