| Theme |
New evolvement in treatment for early rectal cancer |
| Title |
Pocket-creation method (PCM) for rectal endoscopic submucosal dissection (ESD) |
| Author |
Yoshikazu Hayashi |
Department of Medicine, Division of Gastroenterology, Jichi Medical University |
| Author |
Hironori Yamamoto |
Department of Medicine, Division of Gastroenterology, Jichi Medical University |
| [ Summary ] |
Generally, it is believed that rectal ESD is comparatively easier to treat than colonic conditions. However, ESD for tumors near the anal canal presents a delicate problem. If a slightly invasive submucosal carcinoma is there, ESD can play an important role. Because curative resection is achieved with ESD, we can avoid additional surgery involving colostomies. Therefore, it is important to obtain a high-quality specimen with pathology minimumally thermally damaged thick submucosal tissue and of course negative margins. ESD can then be used to produce a correct diagnosis to determine whether the patient needs additional surgery or not. To perform the task, the pocket-creation method (PCM) ESD is the best choice. The reason why is that PCM ESD can stretch the submucosal tissue and safely cut the tissue at minimumally safe distances from the muscle layer. |