Endoscopic Treatment for Esophageal Squamous Cell Carcinoma
Esophageal endoscopic mucosal resection (EMR) was developed in the late 1980s (Makuuchi 1996; Yoshida T 2004; Inoue et al. 1993; Pech et al. 2004). And EMR was widely accepted as the treatment for superficial esophageal Squamous cell carcinoma (SCC). Howe
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Contents 1 Introduction.......................................................................................................................... 143 2 Indications of Endoscopic Resection for Esophageal SCC ............................................... 144 2.1 Absolute Indication .................................................................................................... 144 2.2 Relative Indications .................................................................................................... 144 3 Endoscopic Mucosal Resection........................................................................................... 145 3.1 Procedures................................................................................................................... 145 3.2 Advantage and Disadvantage of EMR ...................................................................... 145 4 Endoscopic Submucosal Dissection (ESD) ........................................................................ 145 4.1 Procedure .................................................................................................................... 145 4.2 Marking and Submucosal Injection ........................................................................... 146 4.3 Mucosal incision......................................................................................................... 146 4.4 Submucosal Dissection............................................................................................... 148 4.5 Hemostasis .................................................................................................................. 150 4.6 Prevention of Bleeding............................................................................................... 150 5 Complications of Esophageal EMR/ESD ........................................................................... 151 References.................................................................................................................................. 153
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Introduction
Esophageal endoscopic mucosal resection (EMR) was developed in the late 1980s (Makuuchi 1996; Yoshida T 2004; Inoue et al. 1993; Pech et al. 2004). And EMR was widely accepted as the treatment for superficial esophageal squamous cell carcinoma (SCC). However, there was limitation in size, and precise resection was
T. Oyama (&) Department of Gastroenerology, Saku Central Hospital, Nagano, Japan e-mail: [email protected]
F. Otto and M. P. Lutz (eds.), Early Gastrointestinal Cancers, Recent Results in Cancer Research 196, DOI: 10.1007/978-3-642-31629-6_9, Ó Springer-Verlag Berlin Heidelberg 2012
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T. Oyama
impossible. Piecemeal resection was performed for big lesions, and local recurrence after piece meal EMR was high (Momma 2007). Therefore, a novel endoscopic treatment, endoscopic submucosal dissection (ESD) was developed to resolve such disadvantage of EMR (Oyama and Kikuchi 2002; Oyama et al. 2005; Fujishiro et al. 2006; Ishihara et al. 2008; Hiroaki et al. 2010). The other endosc
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