Japanese

Endoscopic Treatment for Colorectal Laterally Spreading Tumors(LST)Based on Classification, Special Reference with Hybrid EMR/ESD Koichi Koizumi 1 , Kimiaki Hattori 2 , Go Kuwata 2 , Hajime Anjiki 2 , Sawako Kuruma 2 , Taku Tabata 2 , Shinichiro Horiguchi 3 1Depaetment of Endoscopy, Cancer and Infection Disease Center Tokyo Metropolitan Komagome Hospital, Tokyo 2Department of Gastroenterology, Cancer and Infection Disease Center Tokyo Metropolitan Komagome Hospital, Tokyo 3Department of Pathology, Cancer and Infection Disease Center Tokyo Metropolitan Komagome Hospital, Tokyo Keyword: colon cancer , LST , EMR , hybrid EMR , ESD pp.989-999
Published Date 2010/5/25
DOI https://doi.org/10.11477/mf.1403101957
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 LST are classified into two subtypes : granular types(LST-G)and non-granular types(LST-NG). The incidence of invasive carcinoma was 18.8% in LST-NG, 7.1% in LST-G. In LST-NG, 6.1% of the lesions 10-19 mm in diameter invade to submucosal layer, 23.3% of the lesion 20-29mm in diameter invade to the submucosal layer.

 In 376 lesions of LST, 111 were removed with EMR, 191 with ESD, 54 lesions were removed with hybrid EMR/ESD, which is EMR after incision of the mucosa outside of the lesion. 51 lesions, lager than 40mm, were removed with ESD, 41 were removed en block.

 In 46 lesions smaller than 30mm, 42 were removed en block with hybrid EMR/ESD, on the other hand, 49 of 104 were removed en block with EMR. LST-NG should be removed en block because of its higher malignancy potential compared to LST-G. Hybrid EMR/ESD is a effective procedure for LST-NG, especially with slight fibrosis, in which the diameter is less than 30mm.


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

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