| Theme | Endoscopic Treatment of Upper Gastrointestine: Current Status and Clinical Problems | |
|---|---|---|
| Title | Local Recurrence Including Multiple Lesions after Esophageal EMR | |
| Publish Date | 2004/09 | |
| Author | Haruhiro Inoue | Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author | Yoshitaka Sato | Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author | Tamae Kazawa | Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author | Satoshi Sugaya | Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author | Hitoshi Satodate | Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author | Shin-ei Kudo | Digestive Disease Center, Showa University Northern Yokohama Hospital |
| [ Summary ] | Local recurrence including other multiple lesions, in the esophagus immediately after EMR, were reported to be around 8% of all cases. The rate of multiple lesions in the esophagus is considered to be 8 to 14%. 0-IIa and 0-IIc lesions are observed endoscopically. Elevated or depressed lesions, with clear delineation from the surrounding mucosa are typical. Whitish or reddish color changes are very common with those lesions. To make a diagnosis for 0-IIb type lesions, detection of reddish changes around the primary EMR scar is most important, and dilated IPCL (IPCL-Type IV,V) is also extremely characteristic of severe dysplasia and carcinoma in situ. Those findings are common even in very minute lesions (around 1 mm). The first line treatment for recurrent or multiple lesions of the esophagus is now considered to be repeated EMR. An understanding of IPCL changing patterns in flat lesions is very useful. |
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