INTESTINE Vol.14 No.2(3-4)

Theme Selection of the therapeutic methods (EMR or ESD) for colorectal tumor
Title Indications and techniques for endoscopic piecemeal mucosal resection (EPMR) as treatment for colorectal neoplasms
Publish Date 2010/03
Author Hiroshi Kashida Digestive Disease Center, Showa University Northern Yokohama Hospital
Author Takemasa Hayashi Digestive Disease Center, Showa University Northern Yokohama Hospital
Author Toshihisa Hosoya Digestive Disease Center, Showa University Northern Yokohama Hospital
Author Kunihiko Wakamura Digestive Disease Center, Showa University Northern Yokohama Hospital
Author Yoshiki Wada Digestive Disease Center, Showa University Northern Yokohama Hospital
Author Hirotaka Nishiwaki Digestive Disease Center, Showa University Northern Yokohama Hospital
Author Nobunao Ikehara Digestive Disease Center, Showa University Northern Yokohama Hospital
Author Fuyuhiko Yamamura Digestive Disease Center, Showa University Northern Yokohama Hospital
Author Shin-ei Kudo Digestive Disease Center, Showa University Northern Yokohama Hospital
[ Summary ] Endoscopic mucosal resection (EMR) or endoscopic piecemeal mucosal resection (EPMR) technique, using snares, is still important as one of the treatment methods for colorectal neoplasms even after the advent of endoscopic submucosal dissection (ESD) techniques, which employ special knives. Most early colorectal neoplasmas can be treated with EMR or EPMR techniques. However, the indications for ESD techniques are fairly limited. The procedure time is shorter and the perforation rate is much lower for EPMR than for ESD. On the other hand, local recurrence rates are much higher with the former. Recurrent lesions can usually be treated endoscopically when they are encountered. However, careful and complete resection during the first procedure is most important.
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