大腸腺腫・早期癌の内視鏡切除後のfollow up

Surveillance of Mucosal Colorectal Cancer after Endoscopic Resection

要旨　大腸粘膜内癌の局所再発のリスクとして分割切除や側方発育型腫瘍（LST）などが挙げられる．可能な限り一括切除が望ましいが，分割切除となった場合でも，再発を十分念頭に置いたfollow upを行うことで，局所のコントロールは可能である．また，異時性異所性大腸癌合併の可能性も考え，一括切除を施行しえた場合でも，分割切除に準じたfollow upが重要となる．

　Endoscopic resection has become the preferred technique for removing many early colorectal cancers, but local recurrence after endoscopic resection is a problem that can't be denied. EPMR (endoscopic piecemeal mucosal resection) and LST (laterally spreading tumor) are definite risk factors for local recurrence. For this reason, it is desirable that we excise a mucosal cancer as one piece. However, with EPMR, we can prevent recurrence if we do sufficient follow-up. In addition to these precautions and considering the likelihood of cancers to develop differently according to location and after the lapse of time, even when mucosal cancers are excised as one piece, careful follow-up in the same manner as follow-up for EPMR is necessary.