| Theme | Current Endoscopic Treatment for Colorectal Tumors | |
|---|---|---|
| Title | Indications for Colorectal ESD Including Perspectives for Standardization | |
| Publish Date | 2014/02 | |
| Author | Shinji Tanaka | Department of Endoscopy, Hiroshima University Hospital |
| Author | Nana Hayashi | Department of Endoscopy, Hiroshima University Hospital |
| Author | Kenjiro Shigita | Department of Endoscopy, Hiroshima University Hospital |
| Author | Naoki Asayama | Department of Gastroenterology and Metabolism, Hiroshima University Hospital |
| Author | Soki Nishiyama | Department of Gastroenterology and Metabolism, Hiroshima University Hospital |
| Author | Motomi Terasaki | Department of Gastroenterology and Metabolism, Hiroshima University Hospital |
| Author | Koichi Nakadoi | Department of Gastroenterology and Metabolism, Hiroshima University Hospital |
| Author | Shiro Oka | Department of Endoscopy, Hiroshima University Hospital |
| Author | Kazuaki Chayama | Department of Gastroenterology and Metabolism, Hiroshima University Hospital |
| [ Summary ] | The indications for colorectal ESD as outlined in the Japanese National Health Insurance guidelines consists of "early malignant colorectal neoplasia (K721-4)" and not benign adenoma. Adenoma or early carcinoma being included in diagnostic comments may have a negative impact on countermeasures which will be reimbursed when final pathological diagnoses are made for treatment of adenoma after ESD, which is different from preoperative diagnoses. In the near future limitations on size, under 5 cm, as an indication for colorectal ESD in national health insurance guidelines may be deleted. It is desirable that the price of reimbursement for lesions larger than 5 cm should be greater than that for those under 5 cm because of the necessity of long term treatment and limited manpower, lager amounts of injection solution required and additional use of treatment devises. Indications for colorectal ESD have been proposed by the Colorectal ESD Standardization Implementation Working Group in Japan. | |