| Theme | Training System and Risk Management for Endoscopic Submucosal Dissection (ESD) | |
|---|---|---|
| Title | Histopathological Assessment of Specimens and Preoperative Diagnosis for Endoscopic Submucosal Dissection (ESD) | |
| Publish Date | 2006/08 | |
| Author | Takashi Toyonaga | Department of Gastroenterology, Kishiwada Tokushukai Hospital |
| Author | Eisei Nishino | Department of Pathology, Kishiwada Tokushukai Hospital |
| Author | Takaaki Chikugo | Department of Pathology, Kinki University School of Medicine |
| Author | Kazu Noda | Department of Gastroenterology, Kishiwada Tokushukai Hospital |
| Author | Chie Ueda | Department of Gastroenterology, Kishiwada Tokushukai Hospital |
| Author | Takashi Hirooka | Department of Gastroenterology, Kishiwada Tokushukai Hospital |
| [ Summary ] | The major advantages of endoscopic submucosal dissection (ESD) are the possibility of accurate, minimal resection of the target area, and extensive histopathological assessment of specimens resected in an en bloc fashion. To this end, it is essential to appropriately handle the resected specimen, and verify the preoperative diagnosis. The specimen must be carefully recovered and fixed as extended to reflect the preoperative conditions. After adhering tissue, etc. is removed, the specimen is examined, measured and photographed. Lighting is of paramount importance. The entire specimen must be cut into pieces. When cutting the specimen, incisions are made in a direction which enables an evaluation of the margins. Cutting intervals must be 2 mm for the stomach and large intestine, and less than 2 mm for the esophagus. The cut pieces or the incised specimen must also be photographed. Based on histopathological diagnosis and mapping results, therapeutic effects are determined and the preoperative diagnosis is verified. Since standardized policy is often unalterable after treatment, the endoscopist must always maintain close connections with the pathologist. |
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