title: Effectiveness of endoscopic clipping and computed tomography gastroscopy for the preoperative localization of gastric cancer.
abstract: OBJECTIVE
  Before laparoscopic gastrectomy for gastric cancer can be planned, it is very important to know the precise location of the tumor. The aim of this study was to evaluate 3 methods of predicting the exact location of the tumor: preoperative gastrofibroscopy (GFS), preoperative computed tomography gastroscopy (CT), and intraoperative gastroscopy-guided laparoscopy (Lap).
  
  
  METHODS
  In this study, 15 patients were prospectively identified, and endoscopic clips were preoperatively placed on the proximal 1 cm of the tumor, at the angle on the greater curvature and opposite the angle on the greater curvature. The distances between the pylorus and the proximal tumor clip (PT), the angle clip (PA), the greater curvature clip (PG), and the gastroesophageal junction were measured by preoperative GFS, preoperative CT, intraoperative Lap, and visual inspection (Vis).
  
  
  RESULTS
  PT, PA, and PG values measured by preoperative GFS differed significantly from the Vis values (P < 0.01). However, preoperative CT measurements of PT, PA, and PG did not differ from the Vis values (P = 0.78, P = 0.48, and P = 0.53, respectively). Intraoperative Lap and Vis PT values differed by only 1.1 cm on an average (P = 0.10), but PA and PG values varied by 1.9 and 3.4 cm, respectively (P = 0.01 for both).
  
  
  CONCLUSIONS
  Endoscopic clipping combined with preoperative CT gastroscopy is more useful than preoperative GFS for preoperatively predicting the location of early gastric cancers and will be helpful for planning laparoscopic gastrectomy.
authors: Department of Surgery, Gyeongsang National University School of Medicine, Jinju, Korea. ; Gyeongnam Regional Cancer Center, Jinju, Korea. ; Gyeongsang Institute of Health Sciences, Jinju, Korea.
authors: Sang-Ho
authors: SH
authors: Jeong
authors: Kyungsoo
authors: K
authors: Bae
authors: Chang-Youn
authors: CY
authors: Ha
authors: Young-Joon
authors: YJ
authors: Lee
authors: Ok-Jae
authors: OJ
authors: Lee
authors: Woon-Tae
authors: WT
authors: Jung
authors: Sang-Kyung
authors: SK
authors: Choi
authors: Soon-Chan
authors: SC
authors: Hong
authors: Eun-Jung
authors: EJ
authors: Jung
authors: Young-Tae
authors: YT
authors: Ju
authors: Chi-Young
authors: CY
authors: Jeong
authors: Woo-Song
authors: WS
authors: Ha
keywords: Gastrectomy; Gastroscopy; Laparoscopy; Stomach neoplasms; X-ray computed tomography
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