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Summary
Early gastric cancer accounts for more than 50% of resected gastric cancer cases in Japan. Because of the increased incidence of early gastric cancer, endoluminal minimally invasive intragastric treatments have been developed. The rate of lymph node metastasis is very low in early gastric cancer, especially in mucosal cancer. There are two popular strategies in Japan for the management of patients with mucosal cancer: endoscopic mucosal resection (EMR) and intragastric mucosal resection (IGMR). EMR is more popular: from 1993 to 1997, over 35,000 cases of early gastric cancer have been treated by EMR in Japan. IGMR was developed in 1993, and 256 cases of early gastric cancer, which were not appropriate for EMR because of size and location, have been treated successfully by IGMR. These data suggest that in Japan 20%-30% of patients with early gastric cancer are treated by endoluminal intragastric procedures. In this paper we review the indications for, techniques pertaining to, and outcomes of EMR and IGMR in Japan.