| Theme | Barrett's Esophagus | |
|---|---|---|
| Title | Endoscopic Treatment of Barrett's Esophageal Cancer -- Indications and Methods | |
| Publish Date | 2007/01 | |
| Author | Tsuneo Oyama | Department of Gastroenterology, Saku Central Hospital |
| Author | Akihisa Tomori | Department of Gastroenterology, Saku Central Hospital |
| Author | Kinichi Hotta | Department of Gastroenterology, Saku Central Hospital |
| Author | Shuko Morita | Department of Gastroenterology, Saku Central Hospital |
| Author | Masaki Tanaka | Department of Gastroenterology, Saku Central Hospital |
| Author | Shinichi Furutachi | Department of Gastroenterology, Saku Central Hospital |
| Author | Yoshinori Miyata | Department of Gastroenterology, Saku Central Hospital |
| [ Summary ] | Endoscopic submucosal dissection (ESD) is a novel endoluminal surgery for superficial cancers. Any size or shape resected with ESD. The major indication for endoluminal surgery for esophageal cancer is cases without lymph node metastasis. There have only been a few reports cases of lymph node metastasis with superficial Barrett's esophagus. Bollschweiler reported the incidence of lymph node metastasis with mucosal Barrett's esophageal cancer to be zero. However, the rate for submucosal invasive Barrett's esophageal cancer was 41 %. Therefore, the major indication for endoluminal surgery for Barrett's esophageal cancer is considered to be intramucosal Barrett's cancers. Submucosal fibrosis associated with Barrett's esophagus is more severe than that seen with SCC, because the incidence of reflux esophagitis is higher in Barrett's esophagus. Therefore, greater ESD skill levels will be necessary for treatment of Barrett's esophageal cancer. A diagnosis of a lateral SCC extension is easier than that of Barrett's esophageal cancer, because the lateral extension of SCC may be diagnosed with iodine staining. Superficial lesions may be resected with ESD without limitations as to size or shape. However, if a lateral extension is misdiagnosed, the cut margin may still positive. Because of these factors a precise diagnosis before ESD is necessary. |
|