食道粘膜癌に対する内視鏡的食道粘膜切除術

From December 1992 to October 1994, 15 patients who had esophageal superficial mucosal lesions (18 lesions) underwent endoscopic esophageal mucosal resection (EEMR). Among them, 12 cases and 12 lesions were squamous cell carcinomas. Although perforation complicated this procedure in one patient and hemorrhage in another, these were improvde by conservative treatment. Marked subcutaneous emphysema occurred in the neck and face during EEMR without esophageal perforation in one patient. Therfore the procedure was stopped and the patient underwent radical operation 41 days later. Two of the 12 patients with carcinoma underwent radical operation 30 days after EEMR because pathological study revealed m3 and ly1 in one them and sm1, ly2 and v1 in the other. Radiotherapy was indicated for another patient who had m3, ly0 and v0. In the other patients, the cancerous lesions devaloped within m2, ly0 and v0 except in one who had minimal m3 invasion, and the therapy was completed with only EEMR. The mean period of observation after EEMR was 15.1 months (7-24). Follow-up did not reveal any recurrence of carcinoma in these 9 patients. EEMR seems to be a highly useful method for treatment of esophageal mucosal carcinoma.

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