Gastric Cancer Clinical Trial
Official title:
Efficacy of Narrow Band Imaging Technique for Identifying Resection Margin Status After Gastrectomy for Gastric Cancer
As the proportion of early gastric cancer has been steadily increased in Korea, so has
function-preserving surgery. The function preserving surgery is characterized by the
minimized extent of gastrectomy, so this implies that bilateral margins are getting shorter
than those of standard gastrectomies.
Currently, there is only one way to identify resection margin status in gastric cancer,
'frozen biopsy'. However, it is labor-intensive and time-consuming procedure. In addition,
the results rely on the pathologist's expertise, thereby it showed limitation of its
accuracy; high false negative rate of signet ring cell carcinoma was reported in a previous
study.
Recently, many studies on magnifying endoscopy with narrow band imaging(NBI) demonstrated
that this emerging technique is useful to identify the gastric tumor margin more clearly in
vivo, compared with conventional indigocarmine chromoendoscopy. So it was hypothesized that
NBI may allow reliable delineation of tumor and identification of resection margin status in
the specimen after gastrectomy for gastric cancer.
1. Tumor delineation and identification of resection margin:
After specimen delivery from the abdomen, frozen biopsy is performed before checking
tumor margin. After inspection with NBI, the tumor margin is marked with
electrocauterization. The tumor size and the lengths of both resection margins are
evaluated using a ruler.
2. Pathologic examination:
The specimen is sliced as 4mm interval paralleled to the markings. Tumor size, the status of
both resection margins, and microvessel density are evaluated under the 200 magnified view.
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