The Evaluation of Endoscopic Mucosal Resection for Early Esophageal Carcinoma

Toshitaka Fukumoto, Mario Shimada, Shouji Natsugoe, Shizuo Nakano, Heiji Yoshinaka, Kazusada Shirao, Fumio Kijima, Chikara Kusano, Masamichi Baba, Takashi Aikou

First Department of Surgery, Faculty of Medicine, Kagoshima University

In our department, the esophageal carcinoma in situ (m1) and m2 which invades the proper mucosal layer are usually treated by endoscopic mucosal resection (EMR). From May 1992 to August 1996, a total of 30 patients (38 lesions) with early esophageal carcinoma underwent EMR in our department. In this series, we evaluated the indications of EMR for early esophageal carcinoma by clinical and pathological analysis of those cases, with the following results: 1) Endoscopic type 0-IIb or 0-IIc were found in 73.7% (28/38 lesions). 2) The maximum lengths of tumor were less than 2 cm in 78.9% (30/38 lesions). 3) The depth of cancer invasion estimated by endoscopy was corresponded in 70.6% with histological depth of cancer invasion. 4) Five patients had bleeding which was successfully controlled by electric coagulation or balloon tamponade. 5) There were 3 cases of recurrence and one of metachronous multifocal cancers which could be resected endoscopically again, and no residual lesion were found. As a conclusion, EMR was evaluated as effective treatment for m1 of m2 esophageal carcinoma, not occupied circumferentially, when properly indicated.

Key words
esophageal superficial carcinoma, esophageal early carcinoma, endoscopic mucosal resection, endoscopic ultrasonography

Reprint requests
Toshitaka Fukumoto First Department of Surgery, Faculty of Medicine, Kagoshima University
8-35-1 Sakuragaoka, Kagoshima, 890 JAPAN

Accepted
May 21, 1997

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