| Theme |
Therapeutic Strategy for Early Gastrointestinal Cancers with EMR or ESD |
| Title |
Evaluation of Patients with Esophageal Carcinoma who have Undergone EMR or ESD |
| Author |
Yuichi Shimizu |
Division of Endoscopy, Hokkaido University Hospital |
| Author |
Takeshi Yoshida |
Department of Gastroenterology, School of Medicine, Hokkaido University |
| Author |
Jojo Hirota |
Department of Gastroenterology, School of Medicine, Hokkaido University |
| Author |
Mototsugu Kato |
Division of Endoscopy, Hokkaido University Hospital |
| Author |
Masahiro Asaka |
Department of Gastroenterology, School of Medicine, Hokkaido University |
| [ Summary ] |
The indications for endoscopic submucosal dissection (ESD) for patients with esophageal carcinoma are still controversial because of the risk of mediastinitis as complication and that adequately resected specimens can be obtained by using conventional EMR (suck and cut method). A study was conducted on 152 patients with superficial esophageal carcinoma who have undergone EMR or ESD historically. In ESD group (n = 50), en-block specimens were obtained at a significantly higher rate than in EMR group (n = 102). However, longer operation times were required and it was revealed, that WBC counts were higher the next day. Although ESD provides great benefits for accurate histological evaluation, it is a more invasive technique than conventional EMR. Piece meal resection, using conventional EMR, may be acceptable if expected cutting line inner the lesion leads to a diagnose of intraepithelial extension. |