| Theme |
For Adequate Operation of Colorectal ESD/EMR Guidelines |
| Title |
Perioperative Management of Endoscopic Submucosal Dissection for Colorectal Tumors |
| Author |
Takashi Muramoto |
Department of Endoscopy, NTT Medical Center Tokyo |
| Author |
Ken Ohata |
Department of Endoscopy, NTT Medical Center Tokyo |
| Author |
Tomoaki Tashima |
Department of Endoscopy, NTT Medical Center Tokyo |
| Author |
Yohei Minato |
Department of Endoscopy, NTT Medical Center Tokyo |
| Author |
Kouichi Nonaka |
Department of Endoscopy, NTT Medical Center Tokyo |
| Author |
Nobuyuki Matsuhashi |
Department of Endoscopy, NTT Medical Center Tokyo |
| [ Summary ] |
Endoscopic submucosal dissection (ESD) for early colorectal tumors has been covered by Health Insurance in Japan since April 2012 on the basis of its effectiveness and safety. Colorectal ESD is expected to spread more widely in the future. However, colorectal ESD is more difficult compared with esophageal and gastric ESD because of anatomical features of the colon and technical difficulty of the procedures. It is very important to take care in not only intraoperative management but also in postoperative safety. In our hospital, a clinical pathway comprising a standard stay of 6 days including 1 day for bowel preparation has been applied to all colorectal ESD cases since 2007. Utilization of such a clinical path facilitates quick and proper management of complications including postoperative perforation and bleeding. |