Endoscopic indications for endoscopic mucosal resection of laterally spreading tumours in the colorectum

Background: Laterally spreading tumours (LSTs) in the colorectum are usually removed by endoscopic mucosal resection (EMR) even when large in size. LSTs with deeper submucosal (sm) invasion, however, should not be treated by EMR because of the higher risk of lymph node metastasis. Aims: To determine...

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Bibliographic Details
Published in:Gut 2006-11, Vol.55 (11), p.1592-1597
Main Authors: Uraoka, T, Saito, Y, Matsuda, T, Ikehara, H, Gotoda, T, Saito, D, Fujii, T
Format: Article
Language:English
Subjects:
Biological and medical sciences
Cancer
Colonoscopy - methods
Colorectal Neoplasms - pathology
Colorectal Neoplasms - surgery
EMR
en bloc resection
endoscopic mucosal resection
endoscopic submucosal dissection
endoscopic ultrasonography
Endoscopy
ESD
EUS
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Intestinal Mucosa - pathology
laterally spreading tumour
LST
LST granular type
LST-G type
LST-NG type
LST-non granular type
Lymphatic system
magnification colonoscopy
Medical sciences
Metastasis
Multivariate analysis
Neoplasm Invasiveness
Patient Selection
Retrospective Studies
Stomach, duodenum, intestine, rectum, anus
submucosal
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the digestive system
Tumors
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Summary:Background: Laterally spreading tumours (LSTs) in the colorectum are usually removed by endoscopic mucosal resection (EMR) even when large in size. LSTs with deeper submucosal (sm) invasion, however, should not be treated by EMR because of the higher risk of lymph node metastasis. Aims: To determine which endoscopic criteria, including high magnification pit pattern analysis, are associated with sm invasion in LSTs and clarify indications for EMR. Methods: Eight endoscopic criteria from 511 colorectal LSTs (granular type (LST-G type); non-granular type (LST-NG type)) were evaluated retrospectively for association with sm invasion, and compared with histopathological findings. Results: LST-NG type had a significantly higher frequency of sm invasion than LST-G type (14% v 7%; p
ISSN:0017-5749
1468-3288
DOI:10.1136/gut.2005.087452