| Theme | Progress of Magnifying Colonoscopy | |
|---|---|---|
| Title | Therapeutic efficacy of magnifying endoscopy in endoscopic resection | |
| Publish Date | 1999/03 | |
| Author | Hiro-o Yamano | Division of Gastroenterology, Akita Red Cross Hospital |
| [ Summary ] | The decision to perform complete resection during endoscopic therapy is generally made on the basis of pathological comfirmation of the fact that margins of the resected specimen contain normal glands. In such cases the margins of the resected specimen may be said to be "negative". However, we occasionally experience cases of pathologically in complete resection, in which there has been no recurrence, during the time of our clinical studies. We suggest that there are differences between pathological diagnosis and clinical diagnosis in complete resection, and that the estimation of margins after endoscopic resection,in vivo, is important. We have also conducted studies on the surface structure of colorectal neoplasms (pit patterns) and believe that pit patterns are helpful diagnostic clues, when employing magnifying endoscopy. This study was carried out to evaluate the therapeutic efficacy of using magnifying endoscopy for endoscopic resection, especially piecemeal resection (EPMR). The results suggested that EPMR illustrated many problems with diagnosing residual lesions. During the period from April 1985 to September 1998 we performed 14,228 endoscopic resections, and proceeded with 143 cases of EPMR. In this study, we analyzed 52 cases, which could be sufficiently evaluated in relation to recurrence and residues, for more than six months. The results showed that the rate of recurrence was 7.7% in total. However, the rate when using ordinary endoscopy, only, was higher, at 14.3%. On the other hand, we suppose that complete clinical resection of the resected margin was observed only in glands with normal pit patterns, (type I pit patterns) when using magnifying endoscopy, in vivo. The rate of recurrence (6.3%) was lower in these cases than those seen in ordinary studies and other reports. In conclusion, the clinical effects resulting from the use of magnifying endoscopy, in relation to endoscopic resection, were seen to produce excellent results. |
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