| Theme | Expansion of Indications for Endoscopic Mucosal Resection of Early Gastrointinal Cancer | |
|---|---|---|
| Title | Indications for and Limitations of Endoscopic Mucosal Resection for Colorectal Tumors | |
| Publish Date | 2001/11 | |
| Author | Yutaka Saito | Department of Gastrointestinal Endoscopy, National Cancer Center Hospital / Department of Gastroenterology, Mitsui Memorial Hospital |
| Author | Takahiro Fujii | Department of Gastrointestinal Endoscopy, National Cancer Center Hospital |
| Author | Takahiro Kozu | Department of Gastrointestinal Endoscopy, National Cancer Center Hospital |
| Author | Takahisa Matsuda | Department of Gastrointestinal Endoscopy, National Cancer Center Hospital |
| Author | Yasuo Kakukawa | Department of Gastrointestinal Endoscopy, National Cancer Center Hospital |
| Author | Yasushi Sano | Department of Gastrointestinal Endoscopy, National Cancer Center Hospital East |
| [ Summary ] | Endscopic mucosal resection (EMR) has been in dicated for mucosal lesions. Tumors up to 20mm in diameter can be resected by EMR with enblock resection. EPMR (endoscopic piecemeal mucosal resection) usually has been indicated for LST-granular type. When a LST showed (1) even nodules without depression, or (2) uneven nodules without depression and less than 3cm in diameter, EMR should be the first line treatment because of the low risk of deep submucosal invasion. Sm carcinoma with deep invasion, with vessel involvement, or with poorly differentiated component are usually treated surgically because of risk of the lymph node metastasis. In our institute, well-differentiated adenocarcinoma confined to sm-s (invasion less than 1,500 micron meter from muscularis mucosa) without vessel involvement have no lymph node metastases (0/79). These lesions might be treated by EMR in a near future. | |