| Theme |
For Adequate Operation of Colorectal ESD/EMR Guidelines |
| Title |
Strategies for Local Resection Include EMR or Precutting EMR, Hybrid ESD, and ESD |
| Author |
Akiko Chino |
Division of Gastroenterology, Cancer Institute Hospital of Japanese Foundation Cancer Research |
| Author |
Hiroki Osumi |
Division of Gastroenterology, Cancer Institute Hospital of Japanese Foundation Cancer Research |
| Author |
Kenjiro Morishige |
Division of Gastroenterology, Cancer Institute Hospital of Japanese Foundation Cancer Research |
| Author |
Hirotaka Ishikawa |
Division of Gastroenterology, Cancer Institute Hospital of Japanese Foundation Cancer Research |
| Author |
Teruhito Kishihara |
Division of Gastroenterology, Cancer Institute Hospital of Japanese Foundation Cancer Research |
| Author |
Yoshiro Tamegai |
Division of Gastroenterology, Cancer Institute Hospital of Japanese Foundation Cancer Research |
| Author |
Masahiro Igarashi |
Division of Gastroenterology, Cancer Institute Hospital of Japanese Foundation Cancer Research |
| [ Summary ] |
Colorectal ESD has been covered by the Health Insurance scheme in Japan as of April 2012, and the guidelines committee of the JGES colonic ESD/EMR guidelines was established in April 2014 to clarify the differences between EMR and ESD. In preoperative diagnosis, the qualitative test involving the identification of tumor‒bearing location and assessment of the invasion depth of the adenoma or early colon cancer (cTis, cT1) alone are not necessary. In the cases of cT1 cancers, knowledge of the depth of invasion and an accurate diagnosis are required in order to determine the possibility of secure resection. Decisions regarding the method to be used (EMR/precutting EMR/hybrid ESD or the like) must be made with the consideration of benefits and safety of each method available. Experience and flexibility are required so that a strategy based on individual case characteristics can be adapted. |