検見崎 博樹

Hiroki KENMIZAKI

杏林大学医学部第一外科

First Department of Surgery, Kyorin University, School of Medicine

キーワード : Gastric cancer, Operative ultrasonography, Liver metastasis, Depth of invasion

We have carried out OUS to detect liver metastasis on 50 Patients (groupA) and depth of invasion on 44 patients. In another 50 patients (groupB) we tried to detect liver metastasis by palpation without OUS. Both the 30 cases with no liver metastasis as judged by OUS (groupA) and the 23 cases with no liver metastasis as judged by palpation (groupB) were followed up every 3 months for 2 years after operation by computed tomography and ultrasonography to detect liver metastasis. In groupA, liver metastasis was noted in only 4 cases from 15 months to 2 years (Mean±SD: 20±3.74 months) after operation, while in groupB, liver metastasis was noted in 7 cases within 1 year (Mean±SD: 7.42±3.25 months) after operation (2 cases within only 4 months after operation). Those suggest that GroupB surely included case of occult liver metastasis. In fact we diagnosed 3 cases of small liver metastasis using only OUS. In trying to detect depth of invasion by OUS, we achieved high diagnostic accuracy, 81.8% (36/44). Besides, submucosal spreading from a main lesion that could not be palpated was clearly demonstrated by OUS. OUS was very useful not only for detecting liver metastasis, but also for detecting the depth of cancer invasion and submucosal spreading. During operations on gastric cancer, this information enable surgeon to perform true radical operations.