| Theme |
Surgical Indication for Gastrointestinal Diseases in the Era of Endoscopic Surgery |
| Title |
Surgical Indications for Superficial Colorectal Cancer |
| Author |
Hiroshi Kashida |
Digestive Disease Center, Showa Unirersity Northern Yokohama Hospital |
| Author |
Yui Kudo |
Digestive Disease Center, Showa Unirersity Northern Yokohama Hospital |
| Author |
Jun-ichi Ukegawa |
Digestive Disease Center, Showa Unirersity Northern Yokohama Hospital |
| Author |
Nobunao Ikehara |
Digestive Disease Center, Showa Unirersity Northern Yokohama Hospital |
| Author |
Fuyuhiko Yamamura |
Digestive Disease Center, Showa Unirersity Northern Yokohama Hospital |
| Author |
Shungo Endo |
Digestive Disease Center, Showa Unirersity Northern Yokohama Hospital |
| Author |
Fumio Ishida |
Digestive Disease Center, Showa Unirersity Northern Yokohama Hospital |
| Author |
Shin-ei Kudo |
Digestive Disease Center, Showa Unirersity Northern Yokohama Hospital |
| [ Summary ] |
Superficial colorectal cancers are defined as those limited to the submucosal layer and divided into the slightly invasive and massively invasive categories. Ninety six percent of high grade adenonas and slightly invasive cancers were treated with non-surgical techniques : endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD), etc. Eighty four percent of the massively invasive superficial cancers were treated laparoscopically. Laterally spreading tumors (LSTs) are usually not as invasive as their large diameter might indicate, and therefore there are good indications for their endoscopic treatment. Nongranular type LSTs, 2 to 3 centimeters in diameter, which can be slightly invasive and which are often difficult to lift, due to associated fibrosis, are good candidates for ESD techniques. Detailed observation with magnifying colonopsopy is useful for an accurate diagnosis and to make appropriate determinations concerning therapeutic selection. |