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Endoscopic mucosal resection for esophageal and gastric cancers
Author(s) -
Inoue Haruhiro,
Fukami Norio,
Yoshida Tatsuya,
Kudo ShinEi
Publication year - 2002
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1046/j.1440-1746.2002.02732.x
Subject(s) - medicine , endoscopic mucosal resection , lymph node metastasis , metastasis , lymph node , gastrointestinal tract , gastroenterology , endoscopy , cancer
Abstract Better outcomes for digestive tract cancers are likely to be possible if the tumors are detected in their earliest stages, particularly when they exist as mucosal lesions without lymph node metastases. Early esophageal squamous cell cancers can be detected with high sensitivity and specificity by iodine staining. Only mucosal cancers are suitable for the curative approach of submucosal resection; the rate of metastasis is 4%, compared to a rate of metastasis of 35% in tumors with submucosal spread. In this review, the history of endscopic mucosal resection is reviewed, including the factors that have refined the technique and technical aspects crucial for effective results. The importance of adequate submucosal injection of dilute epinephrine in saline solution is particularly emphasized. The overall efficacy, low rate of complications and such practical aspects as post‐therapeutic care are discussed. In general, mucosal cancers of the gastrointestinal tract have no risk of lymph node metastases and can be curatively managed by refined endoscopic mucosal resection procedures. © 2002 Blackwell Publishing Asia Pty Ltd