| Theme | Therapeutic Strategy for Early Gastrointestinal Cancers with EMR or ESD | |
|---|---|---|
| Title | Endoscopic Treatment for Early Colorectal Cancer Based on Clinicopathological Features and Results of EMR and ESD | |
| Publish Date | 2008/01 | |
| Author | Shiro Oka | Department of Endoscopy, Hiroshima University Hospital |
| Author | Shinji Tanaka | Department of Endoscopy, Hiroshima University Hospital |
| Author | Iwao Kaneko | Department of Medicine and Molecular Science, Graduate School of Biomedical Sciences, Hiroshima University |
| Author | Hiroyuki Kanao | Department of Medicine and Molecular Science, Graduate School of Biomedical Sciences, Hiroshima University |
| Author | Mayuko Hirata | Department of Medicine and Molecular Science, Graduate School of Biomedical Sciences, Hiroshima University |
| Author | Kazuaki Chayama | Department of Medicine and Molecular Science, Graduate School of Biomedical Sciences, Hiroshima University |
| [ Summary ] | Most colorectal tumors larger than 20 mm in size are so-called laterally spreading tumor (LST). Type V pit pattern observed with magnification enable us to easily recognize the cancerous area in LST-G and LST-NG-II a. Data showed that adenomatous large LST-G and LST-NG-II a can be cured with well planned piecemeal EMR. LST-NG-pseudodepressed type (PD) has a relatively high risk of submucosal invasion. However, we cannot accurately recognize the submucosal invasive area in LST-NG-PD with magnifying observation. Therefore, ESD should be applied to large LST-NG-PD for en block resection. On the other hand, the safety and standardization of colorectal ESD have not been yet established. Treatment strategies for choosing EMR or ESD should be discussed based on the clinicopathological characteristics of LST subtype, the endoscopist' skill level and the patients' condition. |
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