| 抄録 |
Backgrounds: Conventional endoscopic mucosal resection (EMR) is a sophisticated procedure which beginners can also perform safely. However, en-block resection of superficial Barrett's adenocarcinoma (SBA) arising from SSBE, which is major in Japan, with EMR is difficult, and ESD is expected to solve this problem. Ames: The aim of this presentation is to assess the effectiveness of ESD for BAC along with demonstration of procedure. Methods: A total of 26 patients who had undergone endoscopic resection for SBA since 2000 were enrolled (19, ESD; 7, EMR). EMR was performed in all cases before 2004, and was performed only one case after 2005. (1)Average procedure time, (2) complications, (3) en-block resection rate, (4) complete resection rate, (5) additional treatment, and (6) prognosis were investigated. Results: (1) ESD/EMR: 70 min/40 min (p=.008). (2)There was no perforation, severe bleeding, nor stenosis. (3)100%/14%. (4)95%/14% (p<.001). (5)Additional operation was performed in 11%/29% and additional endoscopic ablation after ESD/EMR was performed in 0%/100%. Local injection of triamcinolon for prevention of stenosis was performed in a patient with sub-circumferential resection. (6)Sixteen patients who had been followed up for three years or more were analysed. Average follow-up period was 54 month/93 month and 3-years-survival rate was 95%/100%. There is no recurrence and Barrett's cancer related death. Conclusions: ESD is an excellent and safe procedure for complete resection of SBA. |
