The usefulness of preoperative examinations with endoscopic ultrasonography (EUS) in determining operative procedure and ranges of lymph node dissection was examined in 135 patients with gastric cancer. The patients received EUS examinations in order to measure the depth of cancer invasion before undergoing gastrectomies. The EUS results were then compared with the findings of the histological examinations of the resected specimens; the depth of cancer invasion and the degree of lymph node metastasis.
The correct diagnosing rates of m-, sm-, mp-cancer groups and ss-cancer or deeper group were 68.1%, 42.4%, 50.0% and 93.3%, respectively, with an overall accuracy of 68.9%. In an analysis of misdiagnosed cases, there were more overdiagnosed cases than underdiagnosed ones. The cases diagnosed as M and SM by the EUS examination had low potential of lymphnode metastasis; and no cases were observed with n2 or more distant lymphnode metastasis.
It is suggested that positive adoption of conservative surgery with Dl-level lymph node dissection would be appropriate for patients with EUS diagnosis of M or SM.