Endoscopic treatment of early esophageal squamous neoplasia.

Endoscopic treatment of early esophageal squamous neoplasia. Minerva Chir. 2018 May 29;: Authors: Fleischmann C, Messmann H Abstract Esophageal squamous cell carcinoma (ESCC) remains the most common esophageal cancer in the world, though a rising incidence of esophageal adenocarcinoma could be seen during the last decade in the western world. There are several known risk factors for ESCC, such as smoking, alcohol consumption, radiation or others. As there is a risk of lymph node metastasis already in early stages, early endoscopic detection is crucial for curative endoscopic treatment options. Therefore, newest techniqual improvements such as enhancement techniques or virtual chromoendoscopy are helpful for the diagnosis of mucosal carcinoma. Lugol's iodine remains the gold standard to detect early esophageal cancer, however, it should be combined with these newer techniques. For the prediction of invasion depth, a new classification was developed by the Japan Esophageal society. By using magnifying endoscopy and Narrow Band Imaging, the microvascular morphology allows a prediction of invasion depth of early squamous cell carcinoma. Endosopic resection is suitable for patients with early stage ESCC (m1-m2), because of the low risk of lymph node metastasis. EMR should be performed if the lesion is smaller than 15mm, because a R0 resection can be achieved. Larger lesions (>15mm) should be resected via endoscopic submucosal dissectio...
Source: Minerva Chirurgica - Category: Surgery Tags: Minerva Chir Source Type: research