Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.
Ann Transl Med. 2014 Mar;2(3):26. doi: 10.3978/j.issn.2305-5839.2014.03.02.
Endoscopic submucosal dissection (ESD) is an established therapeutic technique for the treatment of gastrointestinal neoplasms. Because it is typically completed as en bloc resection, this technique provides a complete specimen for precise pathological evaluation. On the other hand, ESD is not as widely applied in treating colorectal neoplasms as with gastric cancers, due to its technical difficulty, longer procedure time, and increased risk of perforation. However, some devices that facilitate ESD and improve the safety of the procedure have been recently reported, and the use of the technique has gradually spread worldwide. Endoscopists who begin to perform ESD need to recognize the indications of ESD, the technical issue involved in this procedure, and its associated complications. This review outlines the methods and certain types of devices used for colorectal ESD.
内镜黏膜下剥离术(ESD)是一种成熟的胃肠道肿瘤治疗技术。由于其通常作为整块切除,因此该技术可提供完整的标本进行精确的病理评估。另一方面,由于技术难度较高、手术时间较长且穿孔风险增加,ESD 在结直肠肿瘤治疗中的应用不如胃癌广泛。然而,最近有一些辅助 ESD 并提高手术安全性的设备被报道,该技术的应用已逐渐在全球范围内得到推广。开始进行 ESD 的内镜医生需要认识到 ESD 的适应证、该手术涉及的技术问题及其相关并发症。本文综述了结直肠 ESD 的方法和某些类型的设备。