| Theme |
Aims to improve colorectal ESD safety and efficiency |
| Title |
Indication of colorectal ESD : Discrepancies between medical demands and insurance regulations |
| Author |
Shinji Tanaka |
Department of Endoscopy, Hiroshima University Hospital |
| Author |
Nana Hayashi |
Department of Endoscopy, 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 |
Soki Nishiyama |
Department of Gastroenterology and Metabolism, Hiroshima University Hospital |
| Author |
Hiroyuki Kanao |
Department of Endoscopy, 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 medical indications for colorectal ESD are as follows : 1) Lesions which are difficult to remove en bloc with snare EMR due to size, types such as LST-NG (particularly pseudo-depressed type), lesions exhibiting type VI pit patterns, and large lesions of protruded type suspected of being carcinomatous 2) Lesions with fibrosis due to biopsies or peristalsis 3) Sporadic localized lesions associated with chronic inflammation such as ulcerative colitis and 4) Local residual carcinoma after EMR. Colorectal ESD is currently covered by National Health Insurance in Japan (2012, April-). In this report we explain how we may understand the regulatory strictures of the Japanese National Health Insurance System and how these issues may be resolved. |