Clinical Gastroenterology Vol.23 No.1(4)

Theme Therapeutic Strategy for Early Gastrointestinal Cancers with EMR or ESD
Title Therapeutic Strategy for Early Gastric Cancers Treatment with EMR or ESD
Publish Date 2008/01
Author Shu Hoteya Department of Gastroenterology, Toranomon Hospital
Author Naohisa Yahagi Department of Gastroenterology, Toranomon Hospital
[ Summary ] To clarify the proper therapeutic strategy for early gastric cancer without vestigial remnants and recurrence, the outcomes of EMR and ESD procedures were evaluated. The treatment outcomes of ESD were overwhelmingly better than EMR. The safety of ESD was egual to EMR. EMR must chosen in relation to cost and man power. However, it would theoretically be appropriate even if all cases are selected to ESD. Complete en-bloc resection is necessary to avoid vestigial remnants or recurrence. Judgments concerning curability must be made through accurate histological diagnosis, based on perfect specimens. Therefore, treatment modalities must be considered, when we conduct endoscopic resection, according to the situation of the lesions.
In this study it was concluded that lesions larger than 5 mm should be treated with ESD, although high resection rates were also obtained with EMR in cases where lesions were 5 mm in size or less.
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