| Theme |
Selection of the therapeutic methods (EMR or ESD) for colorectal tumor |
| Title |
Hybrid EMR/ESD treatment for colorectal neoplasia |
| Author |
Koichi Koizumi |
Department of Endoscopy, Tokyo Metropolitan Cancer and Infection Disease Center Komagome Hospital |
| Author |
Kimiaki Hattori |
Department of Gastroenterology, Tokyo Metropolitan Cancer and Infection Disease Center Komagome Hospital |
| Author |
Go Kuwata |
Department of Gastroenterology, Tokyo Metropolitan Cancer and Infection Disease Center Komagome Hospital |
| Author |
Sawako Kuruma |
Department of Gastroenterology, Tokyo Metropolitan Cancer and Infection Disease Center Komagome Hospital |
| Author |
Shinichiro Horiguchi |
Department of Pathology, Tokyo Metropolitan Cancer and Infection Disease Center Komagome Hospital |
| [ Summary ] |
EMR is an effective treatment for broad based lesions of colorectal mucosal or slight submucosal invasive neoplasia. If submucosal injection produces bulges in lesions resembling a dome, EMR may be used as a quick, safe treatment. However, lesions with submucosal fibrosis, are not completely elevated in many cases. These lesions, which may invade the submucosal layer, are often difficult to remove with en block resection employing conventional EMR. Endoscopic submucosal dissection (ESD) seems to be more effective than EMR for curative resection. However, ESD is technically difficult, hazardous, and time consuming. Hybrid EMR/ESD, or EMR after incision of the mucosa outside of the lesion, is suitable for treatment of lesions with slight fibrosis, or lesions which have developed from IBD, with diameters of less than 25 mm. This procedure is also suitable for lesions, located on or behind folds, which are not come entirely visable. |