Theme |
Therapeutic Strategy for Early Gastrointestinal Cancers with EMR or ESD |
Title |
ESD for Early Colorectal Tumors -- Technique and Clinical Outcome |
Author |
Shusei Fukunaga |
Division of Endoscopy, National Cancer Center Hospital |
Author |
Yutaka Saito |
Division of Endoscopy, National Cancer Center Hospital |
Author |
Tuyoshi Kikuchi |
Division of Endoscopy, National Cancer Center Hospital |
Author |
Takeshi Nakajima |
Division of Endoscopy, National Cancer Center Hospital |
Author |
Takahisa Matsuda |
Division of Endoscopy, National Cancer Center Hospital |
[ Summary ] |
Endoscopic submucosal dissection (ESD) which is a widely accepted treatment for early gastric cancer has been introduced for treatment of early colorectal tumors. Indications for ESD, such as a II a (LST-NG) > 20 mm tumor and a tumor showing non-lifting signs, as well as relative indications such as I s + II a (LST-NG) > 40 mm tumors are defined. In order to reduce complications of ESD, attention is paid to many aspects of technique and devices. Colonic-wall perforations, including rectal penetrations, were found in 12 of 293 patients (4 %). Delayed bleeding after ESD was observed in 4 of 293 patients (1 %). It is necessary to establish effective procedures through sufficient knowledge of colorectal ESD. |