J.Jpn. Surg. Soc.. 100(12): 776-781, 1999

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Feature topic

ENDOSCOPIC MUCOSAL RESECTION

Endoscopic mucosal resection (EMR) is a widely used and important technique for the treatment of colorectal neoplasms. The choice must be made between EMR and surgical resection in treating submucosal invading carcinoma. Our study suggests that EMR may be adapted to the treatment of sm_1a and sm_1b carcinoma without invading vessels. Endoscopic findings suggestive of submucosal invasion are depressed-type tumor, large size, hardness, ulceration on the top of the lesion, etc. We have conducted studies on the surface structure of colorectal neoplasms (pit pattern) and showed that pit patterns are useful in the qualitative and quantitative diagnosis of lesions, when employing magnifying endoscopy. The VN-type pit pattern indicates that the lesion is most likely sm-massive cancer. This type of cancer should not be treated by EMR, Althoush minute colorectal cancer can be treated by EMR. We believe that the importance of endoscopic diagnosis and treatment wil increase.

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