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要旨 2000年1月から2005年12月の期間にESDを行い,組織学的深達度がm1,m2であった食道扁平上皮癌症例79例を対象とした.結果:①一括完全切除率93.7%,②偶発症:穿孔0%,遅発穿孔1.3%,③局所再発率0%,④遠隔転移率0%,⑤異時多発食道癌24.1%,⑥ 3年生存率95.1%.考察:食道ESDの偶発症と長期予後はEMRと同等であった.食道ESDはEMRより一括完全切除率が高く詳細な病理学的検討が可能となり,局所再発率が低かった.ESDは食道表在癌の治療に有用であると考える.
Seventy-nine patients who had superficial esophageal squamous cell carcinoma, m1-m2, had been treated by endoscopic submucosal dissection (ESD) in Saku Central Hospital from Jan. 2000 to Dec. 2005.
Result: Complete resection rate was 93.7%. Perforation rate was 0%, delayed perforation rate was 1.3%and all perforated cases were able to be treated by conservative therapy. Local recurrence rate was 0%, metastasis rate was 0%and metachronous cancers were observed in 24.1%. Thee year survival rate was 95.1%.
Conclusion: Complications and long-time survival rate of ESD is the same as those of EMR. Also, the en bloc resection rate of ESD is higher than that of EMR and local recurrence rate of ESD is lower than that of EMR. Therefore, it can be held that ESD is a useful treatment method for superficial esophageal SCC.
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