| [ Summary ] |
Endoscopic examinations predominantly displayed colorectal neoplasms. Endoscopic therapy was used to treat them. The use of endoscopic therapy were for adenoma, mucosal carcinoma and slightly invading submucosal carcinoma, without vessel invasion. However we can not resect large adenoma and invading carcinoma with lymph node metastasis. We must choose laparoscopically assisted surgical resection. This study was carried out to clarify the adaptations of endoscopic and laparoscopic therapy. In the period from April 1985 to June 1999 we have diagnosed 327 cases submucosal invading carcinoma. In this study, we analyzed 323 cases of which could be sufficiently evaluated in relation to degree of submucosal invasion, vessels and lymph node metastasis. The rates of lymph node metastasis for each invading degree, sm1a and sm1b Were O%, sm1c was 2.9%, sm2 was 11.7%, sm3 was 20.4%, and the grand total was 10.9%. There was no lymph node metastasis in submucosal carcinomas without vessel invading. We must resect submucosally invading carcinomas with lymph node metastasis, and estimate the degree of lymph node metastasis caused by invading vessels. And we concluded that the adaptation of endoscopic therapy was for treatment of sm1a and sm1b carcinomas without vessel invasion. Laparoscopic therapy was also useful for submucosally invading carcinomas with vessel invasion of sm1c or greater. |