所属 医学部 医学科（東医療センター） 職種 教授
|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|
|発表者・共同発表者||◎Hiroyuki Kato, Rieko Yamada, Teruhiko Sakamoto, Hiroko Otsuka, Kimiko Kihara, Kiyo Watanabe|
|Santa Cruz, Bolivia|
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.
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.
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