O câncer gástrico remanescente (CGR) surge no estômago residual após cirurgia gástrica prévia. Quando identificado em estágio inicial ou superficial, o manejo concentra-se em obter controle local definitivo da lesão no órgão remanescente — potencialmente sem necessidade de re-operação radical.
O sucesso é definido pela obtenção de ressecção macroscópica completa da lesão sem infiltração linfosvascular observada no exame patológico — critérios que podem permitir evitar intervenção cirúrgica adicional em pacientes selecionados.
DOI: 10.3389/fonc.2024.1457564
Endoscopic resection is first-line therapy in the management of superficial neoplasms throughout the gastrointestinal tract, as well as an increasingly viable therapeutic alternative in the resection of selected small deep lesions throughout the upper and lower gastrointestinal tract.
Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are two well-known endoscopic resection procedures used for advanced gastrointestinal lesions.
In the past, remnant gastric cancer (RGC) was commonly detected at an advanced stage where radical surgical resection was considered the only method for achieving cure. However, completion gastrectomy does not improve survival outcomes compared with endoscopic resection and may even adversely affect the long-term outcomes of patients with early RGC.
Additional surgical resection might be avoided in selected cases that can even present noncurative features after endoscopic resection if macroscopic complete resection is achieved and lymphovascular infiltration is not observed.
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