| Theme |
Current Status of Uprising Strategy for Esophageal Cancer Treatment |
| Title |
Efficacy of and Problems with Endoscopic Submucosal Dissection for Esophageal Squamous Cell Carcinoma Treatment |
| Author |
Manabu Takeuchi |
Department of Gastroenterology, Niigata University Graduate School of Medical and Dental Sciences |
| Author |
Satoru Hashimoto |
Department of Gastroenterology, Niigata University Graduate School of Medical and Dental Sciences |
| Author |
Masaaki Kobayashi |
Department of Endoscopy, Niigata University Medical and Dental Hospital |
| Author |
Yuichi Sato |
Department of Gastroenterology, Niigata University Graduate School of Medical and Dental Sciences |
| Author |
Rintaro Narisawa |
Department of Endoscopy, Niigata University Medical and Dental Hospital |
| Author |
Yutaka Aoyagi |
Department of Gastroenterology, Niigata University Graduate School of Medical and Dental Sciences |
| [ Summary ] |
Esophageal squamous cell carcinoma (SCC) involving the epithelium (EP) or the lamina propria mucosa (LPM) and spreading more than two-thirds of the circumference of the esophagus is considered to be a relative indication for endoscopic resection (ER). This is because of the likelyhood of post-operative strictures. Moreover, ER may indicate MM (muscularis mucosa) or SM1 (< 200 micrometers below the MM) without metastasis being observed through clinical examinations because lymphnode metastasis rates are reported to be approximately 10-15 % for MM or SM1 SCC. However, endoscopic submucosal dissection (ESD) enables us to resect both types of lesions in an en-bloc fashion with no complications.To prevent post operative strictures, we began injecting steroids into artificial ulcer bases after ESD.Additional endoscopic balloon dilation (EBD) was unnecessary in approximately 70 % of semi circumferential ESD cases.Less post EBD treatment was required when employing circumferential ESD than when employing EBD alone.Prognoses for MM or SM1 SCC are considered to be good with additional therapies, such as esophagectomy or chemoradiotherapy, which are based on histopathological examination of ESD resected specimens. At the present time, ESD treatment for lesions with relative indications for ER is considered to be appropriate. |