Endoskopisk dissektion av submukosa vid kolorektala polyper. Lovande minimalinvasiv teknik som medger större resektioner
Engelsk titel: Endoscopic submucosal dissection in colorectal polyps. Promising minimally invasive technique that allows larger resections
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Författare:
Thorlacius, Henrik
;
Uedo, Noriya
;
Toth, Ervin
Email: henrik.thorlacius@med.lu.se
Språk: Swe
Antal referenser: 35
Dokumenttyp:
Översikt
UI-nummer: 12127641
Sammanfattning
Endoscopic mucosal resection (EMR) is a well-established method for removing colorectal polyps. However, the problem with endoscopic mucosal resection (EMR) is that large sessile and flat polyps (>2 cm) usually need to be removed by piecemeal resection. Endoscopic submucosal dissection (ESD) is an effective method for removal of large colorectal tumours in Japan although this technique is not yet widely established in western countries. The advantage of ESD compared to EMR is that large colorectal tumours can be removed en bloc, which facilitates the pathological evaluation of the specimen and reduce the risk of local recurrence compared to EMR. The disadvantage with ESD is that this method is technically challenging to learn and that the risk of perforation is higher than that of EMR. Although most ESD-associated perforations are treated conservatively and rarely require surgical intervention some perforations are indeed fatal. This review demonstrates that ESD is an effective method for removal of large colorectal tumours and that proper training and further standardisation of the ESD procedure in the colon and rectum can improve safety.