Determination of the resection line in early esophageal cancer using intraoperative endoscopic examination with Lugol staining.

Determination of the resection line using intraoperative endoscopic examination with Lugol staining was performed when preoperative examinations such as an esophagogram could not be effectively carried out and the carcinoma was not palpable from the outer surface of the esophageal wall. During the past two years, we performed this technique on eight patients. The carcinoma was restricted within the epithelium in one, the mucosal layer in five, and the submucosal layer in two. Although intraepithelial carcinoma contiguous to the main lesion was seen in six and cancer multiplicity was evident in two, all of the resected stumps were free of any cancer tissue. There have been no cases of recurrence and a limited operation, such as distal esophagectomy, was able to be performed in six. Therefore, intraoperative endoscopic examination is useful for early esophageal cancer.