Operative Unit of Diagnostic and Therapeutic Endoscopy, Department of General and Specialized Surgery and Organ Transplantation "Paride Stefanini", University of Rome "La Sapienza", Rome, Italy.
Gut Liver. 2007 Jun;1(1):12-21. doi: 10.5009/gnl.2007.1.1.12. Epub 2007 Jun 30.
Early gastrointestinal cancers are defined as lesions limited to the mucosa or submucosa without invading the muscularis propria, regardless of the presence of lymph node metastases. Although the natural history of these diseases is basically alike worldwide, its management is quite different between the East and West; aggressive surgery is frequently adopted by Western surgeons, while less invasive techniques are adopted by Asian colleagues. These techniques include endoscopic mucosal resection and endoscopic submucosal dissection which are now accepted as treatments for early gastrointestinal cancers in selected cases. Recent advances in endoscopic detection and treatment techniques, especially in Japan and Korea, have prompted Western endoscopists to learn these techniques. This review addresses recent advances regarding endoscopic resections of early gastrointestinal cancers, which promoted its use in Western countries. In addition, prospective studies on endoscopic resection in Western countries are also described.
早期胃肠道癌被定义为病变局限于黏膜或黏膜下层而未侵犯肌层，无论是否存在淋巴结转移。尽管这些疾病的自然病程在全球范围内基本相似，但东西方的治疗方法却有很大的不同；西方外科医生常采用积极的手术治疗，而亚洲同行则采用侵袭性较小的技术。这些技术包括内镜黏膜切除术和内镜黏膜下剥离术，目前已被接受为某些情况下早期胃肠道癌的治疗方法。内镜检测和治疗技术的最新进展，特别是在日本和韩国，促使西方内镜医生学习这些技术。这篇综述介绍了促进早期胃肠道癌内镜切除在西方国家应用的最新进展。此外，还描述了西方国家内镜切除的前瞻性研究。
