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Endoscopic Submucosal Dissection for Colorectal Lesions with Fibrosis into the Submucosal Layer Toshio Uraoka 1 , Jyoichiro Horii 1 , Hiroyuki Ishii 1 , Osamu Goto 1 , Keita Harada 2 , Hiroyuki Okada 2 , Naohisa Yahagi 1 1Division for Research and Development of Minor Invasive Treatment, Cancer Center, Keio University School of Medicine, Tokyo 2Department of Endoscopy, Okayama University Hospital, Okayama, Japan Keyword: 大腸ESD , 線維化 , 穿孔 , non-lifting sign , 遺残・再発病変 pp.155-163
Published Date 2013/2/25
DOI https://doi.org/10.11477/mf.1403113719
  • Abstract
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 Fibrosis within the submucosal layer in the colorectum is caused by several factors ;(1)cancer invasion into the submucosal layer,(2)iatrogenic : biopsy or injection before endoscopic resection, residual or lesions with local recurrence,(3)chronic effect from bowel spasms,(4)chronic inflammation : inflammatory bowel disease etc. ESD(endoscopic submucosal dissection)is the preferred procedure with the capability of removing en bloc endoscopically even these lesions with severe submucosal fibrosis. However, this procedure requires a high level of skill for each operator due to its technical difficulty and higher risk of perforation. The balance between technical skill and the experience of each operator should be considered, before starting ESD, for safe and successful ESD for such difficult lesions.


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

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