Theme |
Selection of the therapeutic methods (EMR or ESD) for colorectal tumor |
Title |
Indications and techniques for endoscopic piecemeal mucosal resection (EPMR) as treatment for colorectal neoplasms |
Author |
Hiroshi Kashida |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
Author |
Takemasa Hayashi |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
Author |
Toshihisa Hosoya |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
Author |
Kunihiko Wakamura |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
Author |
Yoshiki Wada |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
Author |
Hirotaka Nishiwaki |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
Author |
Nobunao Ikehara |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
Author |
Fuyuhiko Yamamura |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
Author |
Shin-ei Kudo |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
[ Summary ] |
Endoscopic mucosal resection (EMR) or endoscopic piecemeal mucosal resection (EPMR) technique, using snares, is still important as one of the treatment methods for colorectal neoplasms even after the advent of endoscopic submucosal dissection (ESD) techniques, which employ special knives. Most early colorectal neoplasmas can be treated with EMR or EPMR techniques. However, the indications for ESD techniques are fairly limited. The procedure time is shorter and the perforation rate is much lower for EPMR than for ESD. On the other hand, local recurrence rates are much higher with the former. Recurrent lesions can usually be treated endoscopically when they are encountered. However, careful and complete resection during the first procedure is most important. |