| Theme | Therapeutic Strategy for Early Gastrointestinal Cancers with EMR or ESD | |
|---|---|---|
| Title | Treatment Strategy for Colorectal Tumors Using Magnifying Colonoscopy -- Endoscopic Treatment or Surgical Resection ? | |
| Publish Date | 2008/01 | |
| Author | Toshiki Nikami | Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine |
| Author | Shoichi Saito | Department of Endoscopy, The Jikei University School of Medicine |
| Author | Hiroyuki Aihara | Department of Endoscopy, The Jikei University School of Medicine |
| Author | Hiroshi Arakawa | Department of Endoscopy, The Jikei University School of Medicine |
| Author | Mitsuru Kaise | Department of Endoscopy, The Jikei University School of Medicine |
| Author | Hisao Tajiri | Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine / Department of Endoscopy, The Jikei University School of Medicine |
| Author | Masahiro Ikegami | Department of Pathology, The Jikei University School of Medicine |
| [ Summary ] | Endoscopic diagnosis of whether submucosal invasion is less than 1,000 μm or is deeper, is important to decide on treatment for colorectal tumors. Endoscopic treatment is selected for tumors without conventional colonoscopic findings suggesting submucosal cancer. On the other hand, evaluation of pit pattern by magnifying endoscopy is useful to make diagnosis of tumors with those conventional colonoscopic findings. VN pit pattern was a specific indicater for surgical resection. Treatment of type II a / II c tumors with less irregular VI pit pattern, were usually performed with endoscopic resection. Surgical resection for those tumors with highly irregular VI pit, was usually chosen. It was often difficult to diagnose the depth of submucosal invasion of tumors without cropping out on the surface, as seen in type I p / I sp / I s tumors. In such cases, it was considered that magnifying colonoscopy using Narrow Band Imaging (NBI) and endoscopic ultrasonography (EUS) might be useful. | |