| セッション情報 | International Session4(消化器内視鏡学会・消化器病学会合同)Achieving high quality colorectal ESD |
|---|---|
| タイトル | 内IS4-8：Endoscopic submucosal dissection as total excisional biopsy for submucosal invasive colorectal carcinoma |
| 演者 | S. Oka（Department of Endoscopy, Hiroshima University Hospital） |
| 共同演者 | S. Tanaka（Department of Endoscopy, Hiroshima University）, K. Chayama（Department of Gastroenterology and Metabolism, Hiroshima University Hospital） |
| 抄録 | Background and Aim: Histologic information obtained from the entire endoscopic submucosal dissection (ESD) specimen is important for therapy selection in submucosal invasive colorectal carcinoma (SM-CRC). The aim of this study is to clarify the usefulness of ESD as total excisional biopsy for SM-CRCs. Methods: The vertical tumor margin-positive (VM+) rate was retrospectively assessed for 84 SM-CRCs who underwent ESD in our institution between June 2003 and March 2012. Lesions were classified into 2 groups (Group A, 43 cases: both magnifying endoscopy (ME) and endoscopic ultrasonography (EUS) were performed, Group B, 41 cases: only ME was performed. EUS findings were classified into 3 categories; EUS-M, EUS-SM-s and EUS-SM-d, as we previously reported. Results: ESD resulted in VM+ in 8 cases (9.5%). In clinical M or SM-s cases, the VM+ rate in Group A (0%, 0/32) was significantly lower than that in Group B (21.2%, 7/33) (p=0.011). In clinical SM-d cases, there was no significant difference in VM+ rate between Group A (11.1%, 1/11) and Group B (0%, 0/8). Poor-differentiation was seen at the deepest invasive portion in 6 VM+ cases. Conclusion: ESD after EUS is a useful method as complete total en bloc excisional biopsy for SM-CRCs. |
| 索引用語 | ESD, Submucosal invasive colorectal carcinoma |