| Theme |
New evolvement in treatment for early rectal cancer |
| Title |
Prevention and measures against complications of endoscopic submucosal dissection for rectum, stenosis, and implantation |
| Author |
Tomoyuki Ishigaki |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Shin-ei Kudo |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Takemasa Hayashi |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Tatsuya Sakurai |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Naoya Toyoshima |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Toyoki Kudo |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Kunihiko Wakamura |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Hideyuki Miyachi |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Fumio Ishida |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| [ Summary ] |
Even for large lesions, the era when en bloc resection with endoscopic submucosal resection (ESD) is possible has arrived. In the rectum, the risk factors of stenosis and the effectiveness of steroid treatment for stenosis prevention have not been proved. In our hospital, the initial colonoscopy after ESD is basically enforced after 6 months. If symptoms such as stomach ache are observed before that, oral treatment will be initiated. However, if the symptoms are not improved, we endoscopically evaluate for possible stenosis. A retrospective study of stenosis after rectal ESD in our hospital showed that none of the stenosis cases were observed <90 % of the ulcer surface after ESD. Although prophylactic steroid therapy was not administered, all three cases with stenosis were conservatively treated with 1-3 endoscopic dilatations. In our hospital, we cleans the ulcer surface after ESD with more than 500 ml of physiological saline as prevention of post implantation after ESD. |