Endoscopic Diagnosis of Submucosal Invasive Colorectal Cancer Resected Completely by EMR Hiroshi Kawano 1 , Osamu Tsuruta 1,2 , Tetsuhiro Noda 1 , Shuichiro Nagata 1 , Yasuhiko Maeyama 1 , Keiko Arita 1 , Shin Hasegawa 1 , Keita Nakahara 1 , Keiichi Mitsuyama 1 , Makiko Yasumoto 3 , Jun Akiba 3 , Michio Sata 1 1Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan 2Division of Endoscopy, Kurume University School of Medicine, Kurume, Japan 3Division of Pathology, Kurume University School of Medicine, Kurume, Japan Keyword: 大腸SM癌 , 熱変性 , 内視鏡的摘除 , 通常内視鏡観察 , 深達度診断 pp.1485-1496
Published Date 2011/9/25
DOI https://doi.org/10.11477/mf.1403102357
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 Tissue at the submucosal layer denatured by high frequency electric current at the time of EMR prevents correct histological diagnosis. So, if it's thought highly probable that tissue is denatured by this process, the lesion must be resected surgically. We investigated 255 submucosal invasive colorectal cancers(excluding Ip type cancer)to clarify the depth of submucosal invasion of lesions whose tissues were suspected to have been denatured by high frequency electric current, and their endoscopic findings. The results were that the mean depth of submucosal invasion was 3,965μm in the protruded(Is, Isp)SM carcinomas, and 1,289μm in superficial type SM carcinomas. We must observe carefully the presence of poor extension at protruded SM carcinomas and the presence of remarkable depression, impaired extensibility at the circumference of the lesions and expansive appearance at superficial type SM carcinomas in order to diagnose the lesion mentioned above with conventional endoscopy. Magnifying observation of vascular and surface pattern using NBI(narrow band imaging), and pit pattern is useful for diagnosing the depth of superficial type SM carcinoma.

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