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At first an analysis is presented of 656 patients with early carcinoma of the stomach, which had been diagnosed during the last 10 years. Most frequently found were depressed or excavated lesions (type IIc, III). 53% of all lesions were located in the mucosa only, in 8.3% lymph nodes were infiltrated, - mostly in such cases, where the primary tumor was located in the antrum, where submucosal layers where involved, or where poor differentiated adenocarcinoma or signet-ring cell carcinoma were present. Diagnostic criteria of minute early gastric carcinoma are discussed. In a second part diagnostic importance of endoscopic sonography is described, especially its importance in regard to estimating depth of infiltration of the tumor. New possibilities of using laser to destroy very small tumors and to treat in a palliative manner malignant stenosis are discussed as well.