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Endoscopic Strategy for Superficial Middle and Hypopharyngeal Tumors Haruhiro Inoue 1 , Yoshitaka Sato 1 , Masayuki Inui 1 , Satoshi Sugaya 1 , Noriko Odaka 1 1Digestive Disease Center, Showa University Northern Yokohama Hospital Keyword: 中・下咽頭癌 , IPCL , NBI , 食道表在癌 , 食道粘膜癌 pp.1270-1276
Published Date 2005/8/25
DOI https://doi.org/10.11477/mf.1403100151
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 Superficial lesions in the middle and hypopharynx were firstly detected as the same kind of lesions as superficial esophageal cancer. Most of the lesions were observed as reddish patches and the others were detected as whitish slight elevations. Both kinds of lesions were confirmed with conventional bite biopsy.

 Magnifying endoscopy revealed precise characteristics of the minute lesions in the pharynx. IPCL type IV and V have, to a great extent, the characteristics of high grade intraepithelial neoplasia which includes carcinoma in situ. (Similar characteristics are also found in esophageal cancer) High resolution endoscopy with magnification enables the detection of high grade intraepithelial neoplasiia, even less than 2 mm in diameter.

 When we suspect carcinoma in situ with no lymph node metastasis, EMR becomes the first line of treatment, which enables precise histopathological analysis. In order to avoid respiratory insufficiency just after the treatment, general anesthesia under intratracheal intubation becomes mandatory when the treatment area involves a laryngeal lesion. Major mucosal injury to the tracheal area demands temporay tracheostomy.

 As the laryngo-pharyngeal region is structurally complicated, EMR using small caliber endoscopy is necessary.


Copyright © 2005, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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