| Theme |
New evolvement in treatment for early rectal cancer |
| Title |
Endoscopic submucosal dissection for anorectal tumors, close to dentate line |
| Author |
Kenjiro Shigita |
Endoscopy and Medicine, Graduate School of Biomedical & Health Sciences, Hiroshima University |
| Author |
Shinji Tanaka |
Endoscopy and Medicine, Graduate School of Biomedical & Health Sciences, Hiroshima University |
| Author |
Yuzuru Tamaru |
Gastroenterology and Metabolism, Graduate School of Biomedical & Health Sciences, Hiroshima University |
| Author |
Nana Hayashi |
Endoscopy and Medicine, Graduate School of Biomedical & Health Sciences, Hiroshima University |
| Author |
Shiro Oka |
Endoscopy and Medicine, Graduate School of Biomedical & Health Sciences, Hiroshima University |
| Author |
Kazuaki Chayama |
Gastroenterology and Metabolism, Graduate School of Biomedical & Health Sciences, Hiroshima University |
| [ Summary ] |
Lower rectal lesions near the dentate line can be difficult to remove endoscopically because of the risk of bleeding from the rectal venous plexus. In addition, sensory nerves in the squamous epithelium below the dentate line make pain likely during the procedure. Moreover, the narrow lumen in the proximity of the anal sphincter makes maintaining a good visual field difficult. Endoscopic submucosal dissection (ESD) has the therapeutic advantage over conventional endoscopic mucosal resection of colorectal tumors and enables endoscopists to achieve higher en bloc resection rates, resulting in enhanced curability and more accurate histopathological assessment. Regardless of the presence of hemorrhoids, ESD for anorectal tumors close to the dentate line is a safe and effective therapeutic method with pain control by local injection of lidocaine and correct handling of the venous plexus from the anal side using hemostatic forceps. |