シモジマ　リエコ   下嶋　理恵子    所属   医学部 医学科（附属足立医療センター）    職種   非常勤講師
言語種別	英語
発表タイトル	Endoscopic treatment for colorectal carcinoma and precancerous lesions: especially efficacy of endoscopic submucosal dissection (ESD)
会議名	13th Bolivia-Japan international symposium of gastroenterology
学会区分	国際学会及び海外の学会
招聘	招聘
発表形式	口頭
講演区分	シンポジウム・ワークショップ パネル（指名）
発表者・共同発表者	◎Hiroyuki Kato, Rieko Yamada, Teruhiko Sakamoto, Hiroko Otsuka, Kimiko Kihara, Kiyo Watanabe
発表年月日	2016/11/10
開催地 （都市, 国名）	Santa Cruz, Bolivia
概要	Introduction Colorectal carcinoma (CRC) is a second major cause of cancer morbidity and mortality in Japan. It is important to have early diagnosis and endoscopic removal of CRC and precancerous lesions. We have been treating many colorectal lesions endoscopically, so we review the safety and effectiveness of the endoscopic treatment. Patients and methods We used many endoscopic techniques in proportion to the lesions, for example snare polypectomy, endoscopic mucosal resection (EMR), piecemeal EMR, EMR using cap fitted method and ESD. We performed more than 600 colorectal lesions resected by ESD between 2005 and 2016. Colorectal ESD was performed using sizers typed forceps mainly. Clinicopatholgical data, technical methods, complications and outcome were analyzed. Results We could endoscopically treat lesions at every location in the large intestine, even a cancer in the diverticulum or huge rectal cancer on the dentate line. In ESD, the rate of en bloc resection was more than 95.0%. The average diameter was about 33mm (range 4-120mm). As for complications, retroperitoneal air was found in 1.8%. Perforation cases were experienced in only 3 (0.5%), but all perforation holes could be closed by endoscopic clips without emergency surgery. Only two cases recurred after ESD and they could heal by endoscopic treatment again. Conclusions Endoscopic treatment for early CRC and precancerous lesions is safe and effective. ESD could be performed in all sites, and even a large lesion was able to be resected en bloc. There were few complications and recurrences, and all complications could be controlled by endoscopic technique