| 特集名 | EMRの問題点 | |
|---|---|---|
| 題名 | 遺残再発病変と追加治療 (1) 内視鏡的摘除術後の局所遺残再発病変の評価と追加治療 | |
| 発刊年月 | 1999年 01月 | |
| 著者 | 松永 厚生 | 仙台市医療センター消化器内科 |
| 【 要旨 】 | 要旨はありません。 | |
| Theme | Problems of endoscopic mucosal resection in colorectal neoplasia | |
|---|---|---|
| Title | Evaluation of remnant or recurrent colonic lesions after endoscopic mucosal resection (EMR) and their additional treatment | |
| Author | Atsuo Matsunaga | Department of Gastroenterology, Sendai City Medical Center |
| [ Summary ] | It is useful to evaluate colonic lesions histologically in specimens obtained by endoscopic mucosal resection (EMR) for early detection of remnant or recurrent tumors and to plan adequate additional treatment. 1) When a colonic lesion was first resected by using EMR and was diagnosed as an adenoma, a mucosal carcinoma or a carcinoma, with minute submucosal invasion histologically, a remnant or recurrent tumor was usually detected as a small elevated lesion adjacent to the scar, through EMR. Secondarily, EMR, polypectomy, hot biopsy, coagulation or combinations there of were applied as additional treatments. 2) When the first endoscopically resected lesion was found to be a carcinoma with massive invasion into the submucosa, recurrent carcinoma was found in the form of two types of tumor, namely, the intraluminal type or the extraluminal type, showing tumor growth toward the musocal side and serosal side, respectively. In such cases, even if no remarkable change, except a scar, was observed endoscopically, invasive carcinoma was sometimes present in the submucosa and/or a deeper layers. Therefore, surgical resection is necessary in such cases. |
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