| Theme |
Selection of the therapeutic methods (EMR or ESD) for colorectal tumor |
| Title |
Indications for colorectal ESD |
| Author |
Shinji Tanaka |
Department of Endoscopy, Hiroshima University Hospital |
| Author |
Sayaka Ohba |
Department of Endoscopy, Hiroshima University Hospital |
| Author |
Aki Matsumoto |
Department of Gastroenterology, Hiroshima University Hospital |
| Author |
Hiroyuki Kanao |
Department of Endoscopy, Hiroshima University Hospital |
| Author |
Shiro Oka |
Department of Endoscopy, Hiroshima University Hospital |
| Author |
Kazuaki Chayama |
Department of Gastroenterology, Hiroshima University Hospital |
| [ Summary ] |
According to the efficacy of endoscopic mucosal resection (EMR) and the clinicopathological characteristics of colorectal tumors, the indications for colorectal ESD implementation are as follows : 1) lesions which are difficult to remove en bloc with a snare EMR due to size, such as those in the LST-NG category (particularly the pseudo-depressed type), lesions exhibiting type VI pit patterns, shallow submucosal invasive carcinoma, large depressed type tumors and large protruded type lesions suspected to be carcinoma. 2) lesions with fibrosis due to biopsy or peristalsis. 3) sporadic localized lesions in chronic inflammation, such as ulcerative colitis. 4) local residual carcinoma after EMR.
Colorectal tumors should be efficiently treated with modalities appropriately selected from the choices of EMR, ESD or surgical resection after precise preoperative diagnosis employing techniques such as magnifying colonoscopy. |