| [ Summary ] |
Mucosal cancers of the esophagus can be treated by endoscopic mucosal resection(EMR) with minimal invasion and preservation of normal esophageal function. Three basic techniques have been established in Japan : the so-called double channel technique, the EEMR-tube technique and the EMR-cap technique. The EEMR-tube and EMR-cap techniques are available to resect larger specimens than the double channel technique. On the other hand, the double channel technique allows precise resection which achieves complete resection of a mucosal cancer by minimal defect of the esophageal mucosa. The depth of cancer invasion is one of most important indications for EMR. Mucosal cancers confined to the lamina propria mucosae are the optimal candidates for EMR, for they seldom have lymph node metastasis. The size of the lesion is also important, for esophageal stricture after EMR is frequent in cases with mucosal defects over three quarter the circumference of the esophagus. Complications of EMR such as ulcer bleeding, perforation and mediastinal emphysema were infrequent and the majority of complication could be treated conservatively. Esophageal strictures could be dilated by bouginage and none of the patients needed additional treatment. There was no significant difference of five-year survival rate between patients with mucosal cancer of the esophagus treated by EMR versus esophagectomy. |