| 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IS4-9：Can colorectal endoscopic submucosal dissection be effectively applied on a widespread international basis?
|
| 演者 |
T. Uraoka（Division of Research and Development for Minimally Invasive Treatment, Cancer Center, School of Medicine, Keio University） |
| 共同演者 |
J. Horii（Division of Research and Development for Minimally Invasive Treatment, Cancer Center, School of Medicine, Keio University）, N. Yahagi（Cancer Center, Keio University） |
| 抄録 |
Colorectal endoscopic submucosal dissection (CR-ESD) has been proven safe and effective when performed by highly experienced endoscopists although its use is not as widespread even in Japan as gastric ESD. Western endoscopists infrequently perform CR-ESD because of its greater technical difficulty; considerably longer procedure time than endoscopic mucosal resection (EMR) particularly for less experienced endoscopists in the initial stages of the learning curve; and higher risk of perforations than EMR. Unfortunately, no formal educational or clinical training programs or relevant guidelines currently exist on establishing the most effective training strategy for acquiring the necessary CR-ESD skills. In addition, there are some important differences between Japan and Western countries relative to their medical environments and clinical practice settings for performing CR-ESD. As a result of such differences, appropriate guidelines preferably including development of a suitable training system are needed for ensuring safe and effective CR-ESDs. Use of gastric and colorectal animal models is strongly recommended along with accumulating the required procedural experience on a step-by-step basis from the rectum to the colon. Continued advances and refinements in CR-ESD techniques, instruments, devices and equipment will also be necessary to further reduce the longer procedure times and higher risk of complications before adoption of CR-ESD can be realistically considered on a widespread international basis. |
| 索引用語 |
Colorectal endoscopic submucosal dissection, Training |
