| 特集名 | 大腸カルチノイド -- 最新の治療戦略 | |
|---|---|---|
| 題名 | 内視鏡的治療の適応と限界 (3) 直腸カルチノイド腫瘍に対する内視鏡治療の適応と治療法の工夫 | |
| 発刊年月 | 2002年 05月 | |
| 著者 | 小林 清典 | 北里大学東病院消化器内科 |
| 著者 | 五十嵐 正広 | 北里大学東病院消化器内科 |
| 著者 | 勝又 伴栄 | 北里大学東病院消化器内科 |
| 著者 | 大谷 剛正 | 北里大学東病院外科 |
| 著者 | 三富 弘之 | 北里大学東病院病理 |
| 【 要旨 】 | 要旨はありません。 | |
| Theme | Colorectal carcinoid tumors -- New strategy of treatment | |
|---|---|---|
| Title | Indication of endoscopic polypectomy and usefulness of 2 channel method for rectal carcinoid tumors | |
| Author | Kiyonori Kobayashi | Department of Gastroenterology, Kitasato University East Hospital |
| Author | Masahiro Igarashi | Department of Gastroenterology, Kitasato University East Hospital |
| Author | Tomoe Katsumata | Department of Gastroenterology, Kitasato University East Hospital |
| Author | Yoshimasa Otani | Department of Surgery, Kitasato University East Hospital |
| Author | Hiroyuki Mitomi | Department of Pathology, Kitasato University East Hospital |
| [ Summary ] | We mainly examined the indications for endoscopic polypectomy for rectal carcinoid tumors, we also evaluated the effectiveness of endoscopic ultrasonography (EUS) in diagnosing carcinoid tumor invasion and the usefulness of two channel scopes for endoscopic polypectomy. We examined sixty cases (60 lesions) with rectal carcinoid tumors. Thirty eight lesions (63%) were treated with endoscopic polypectomy. The results were as follows: 1) The size of the tumors in fifty two lesions was less than 10mm in diameter. Invasion was limited to the submucosal layer in fifty five lesions, and spread to the muscularis propria layer in five other lesions. Small tumors (less than 10mm in diameter) with muscularis propria invasion and/or lymphnode metastasis were not seen in these cases. 2) We performed EUS examinations to evaluate carcinoid tumor invasion in forty six lesions. EUS was correctly diagnosed in all lesions. 3) In endoscopically resected lesions, thirty two lesions (84%) treated by using the two channel scope, and another six lesions were treated by using a one channel scope. In relation to the correlation between frequency of invasion of carcinoid tumor at the resected margin and method of endoscopic polypectomy, endoscopic polypectomy using a two channel scope was a more useful therapeutic method than that using a one channel scope. In conclusion, endoscopic polypectomy is a useful therapeutic method for small rectal carcinoid tumors (less than 10mm in diameter) with out lymph-vascular infiltration or muscularis propria invasion. We also concluded that EUS is useful for diagnosing carcinoid tumor invasion, and that the two channel scope is valuable in completing resection of small rectal carcinoid tumors through endoscopic polypectomy. |
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