| 特集名 | EMRの適応と限界 | |
|---|---|---|
| 題名 | 局所遺残からみた適応と限界 (3) 大腸上皮性腫瘍に対する内視鏡的切除術の適応と限界 | |
| 発刊年月 | 1998年 11月 | |
| 著者 | 趙 栄済 | 京都第二赤十字病院消化器科 |
| 【 要旨 】 | 要旨はありません。 | |
| Theme | Indication and limitation of endoscopic mucosal resection in colorectal neoplasia | |
|---|---|---|
| Title | Endoscopic resection for colorectal epithelial tumor | |
| Author | Eisai Chou | Department of Gastroenterology, Kyoto Second Red Cross Hospital |
| [ Summary ] | Endoscopic resection (ER) including EMR has been used as a useful method for non-invasive removal of colorectal epithelial tumors. Frorn August of 1989 to March of 1998, ER was used in 3,899 cases of tumorous lesions of the colon and rectum. The morphological features of the lesions were as follows ; 378 were of the pedunculated type, 679 semi-pedunculated, 2,041 sessile, 743 flat-elevated, 2 flat and 56 depressed. The histological analysis of the resected specimens showed 3,505 with adenoma, 349 with mucosal carcinoma, 45 with submucosal carcinoma. In this series, single resection was successful for 3,843 lesions and piecemeal resection was required for 56 lesions. The maximum diameter of the lesions was 40 mm for single resection and 60mm for piecemeal resection. Complete resection by ER was possible in 3,885 of 3,899 lesions(99.6%) and incomplete resection was used for 14 lesions ; 11 with positive lateral margins (3 with adenoma and 8 with carcinoma) and 3 with positive vertical margins (3 with submucosal carcinoina). The diagnosis of depth of submucosal invasion is extremely important for the endoscopic treatment of colorectal tumors. When EUS diagnosis was investigated whether the depth of tumor invasion within sml or beyond sm2, the overall accuracy rate of EUS was 87% (34/39). EUS is an important preoperative diagnostic procedure for determining the depth of cancer invasion. ER can be used for the treatment of colorectal epithlial tumors by using EUS for the determination of indications for therapeutic methods. |
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