Evaluation of Endoscopic Mucosal Resection for Laterally Spreading Rectal Tumors

Tamura, Shinji; Nakajo, Kazuo; Yokoyama, Yuta; Ohkawauchi, Koji; Yamada, Terumasa; Higashidani, Yoshifumi; Miyamoto, T; Ueta, Hiroshi; Onishi, Saburo

doi:10.1055/s-2004-814204

Cited by 77 publications

(57 citation statements)

References 19 publications

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“…On the basis of precise preoperative diagnosis with magnifying endoscopy, adenomatous lesions or focal carcinoma in adenomas C2 cm in diameter, for which en bloc snare EMR is not indicated, can be completely resected using deliberate piecemeal EMR to avoid segmentation of the carcinomatous area without compromising pathological diagnosis [2]. Although the local recurrence rate associated with piecemeal resection is high compared with that after en bloc resection [31,32,[47][48][49][50][51][52], most local recurrent lesions are adenomas. Cure is possible with additional endoscopic treatment for local recurrent intramucosal lesions [47,49,52,53].…”

Section: Cq In Which Types Of Colorectal Tumors Is It Acceptable To mentioning

confidence: 99%

Evidence-based clinical practice guidelines for management of colorectal polyps

et al. 2015

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Background Recently in Japan, the morbidity of colorectal polyp has been increasing. As a result, a large number of cases of colorectal polyps that are diagnosed and treated using colonoscopy has now increased, and clinical guidelines are needed for endoscopic management and surveillance after treatment. Methods Three committees [the professional committee for making clinical questions (CQs) and statements by Japanese specialists, the expert panelist committee for rating statements by the modified Delphi method, and the evaluating committee by moderators] were organized. Ten specialists for colorectal polyp management extracted the specific clinical statements from articles published between 1983 and September 2011 obtained from PubMed and a secondary database, and developed the CQs and statements. Basically, statements were made according to the GRADE system. The expert panel individually rated the clinical statements using a modified Delphi approach, in which a clinical statement receiving a median score greater than seven on a nine-point scale from the panel was regarded as valid. Results The professional committee created 91CQs and statements for the current concept and diagnosis/treatment of various colorectal polyps including epidemiology, screening, pathophysiology, definition and classification, diagnosis, treatment/management, practical treatment, complications and surveillance after treatment, and other colorectal lesions (submucosal tumors, nonneoplastic polyps, polyposis, hereditary tumors, ulcerative colitis-associated tumor/carcinoma). Conclusions After evaluation by the moderators, evidence-based clinical guidelines for management of colorectal polyps have been proposed for 2014.

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Section: Cq In Which Types Of Colorectal Tumors Is It Acceptable To mentioning

confidence: 99%

Evidence-based clinical practice guidelines for management of colorectal polyps

et al. 2015

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“…On the other hand, ESD has some disadvantages such as a long operating time, a high frequency of complications, and the need for a high level of technical skill [3][4][5]. Due to the risk of feces and bacteria entering the abdominal cavity and causing severe peritonitis if perforation occurs, most studies of ESD focus on the lesions of the upper gastrointestinal tract.…”

Section: Abstract Colorectum á Endoscopic Submucosal Dissection á Neomentioning

confidence: 99%

Endoscopic submucosal dissection for colorectal epithelial neoplasm

2009

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“…Various image-enhanced endoscopy techniques, such as chromoendoscopy [4,5], narrow-band imaging [6,7], autofluorescence imaging [8] and confocal laser endomicroscopy [9], have improved the detection and characterization of colorectal neoplasms. However, laterally spreading tumors (LSTs) are still difficult to detect with such modalities [10,11,12,13,14]. LST-nongranular type (LST-NG) is particularly difficult to visualize even with a large tumor size, which has a higher potential risk of lymph node metastasis and should be treated by endoscopic submucosal dissection (ESD) [14,15,16].…”

Section: Introductionmentioning

confidence: 99%

A Pilot Study of Fluorescent Imaging of Colorectal Tumors Using a γ-Glutamyl-Transpeptidase-Activatable Fluorescent Probe

Sato¹,

Abe²,

Saito³

et al. 2015

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Backgrounds/Aim: Colorectal laterally spreading tumors (LSTs) are sometimes difficult to visualize even with image-enhanced endoscopy. γ-Glutamyl-transpeptidase (GGT) is a cell surface-associated enzyme that is overexpressed in various types of human cancers. Furthermore, GGT expression is higher in colorectal cancer cells than in normal colorectal mucosa. γ-Glutamyl hydroxymethyl rhodamine green (gGlu-HMRG), an activatable fluorescent probe, is nonfluorescent under a neutral pH and normal cellular environment; however, it turns highly fluorescent upon reaction with GGT. We evaluated ex vivo fluorescent imaging of colorectal LSTs using this GGT-activatable fluorescent probe. Methods: Between March 2013 and March 2014, 30 endoscopically resected colorectal LSTs were prospectively included in this study. Each was analyzed by first taking a baseline image before spraying, then spraying with gGlu-HMRG onto the freshly resected specimen, and finally taking fluorescent images 15 min after spraying with a dedicated imaging machine. Results: Of the LSTs, 67% rapidly showed positive fluorescent activity. These activities were shown in adenoma (54%) and carcinoma in adenoma (76%), and in LST-granular type (80%) and LST-nongranular type (40%). Conclusion: Topically spraying gGlu-HMRG enabled rapid and selective fluorescent imaging of colorectal tumors owing to the upregulated GGT activity in cancer cells.

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Evaluation of Endoscopic Mucosal Resection for Laterally Spreading Rectal Tumors

Abstract: For early detection of recurrence and successful endoscopic cure, further colonoscopic examination within a few months after the first treatment is necessary.

Cited by 77 publications

References 19 publications

Evidence-based clinical practice guidelines for management of colorectal polyps

Evidence-based clinical practice guidelines for management of colorectal polyps

Endoscopic submucosal dissection for colorectal epithelial neoplasm

A Pilot Study of Fluorescent Imaging of Colorectal Tumors Using a γ-Glutamyl-Transpeptidase-Activatable Fluorescent Probe

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Evaluation of Endoscopic Mucosal Resection for Laterally Spreading Rectal Tumors

Abstract: For early detection of recurrence and successful endoscopic cure, further colonoscopic examination within a few months after the first treatment is necessary.

Cited by 77 publications

References 19 publications

Evidence-based clinical practice guidelines for management of colorectal polyps

Evidence-based clinical practice guidelines for management of colorectal polyps

Endoscopic submucosal dissection for colorectal epithelial neoplasm

A Pilot Study of Fluorescent Imaging of Colorectal Tumors Using a &#947;-Glutamyl-Transpeptidase-Activatable Fluorescent Probe

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Product

Resources

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A Pilot Study of Fluorescent Imaging of Colorectal Tumors Using a γ-Glutamyl-Transpeptidase-Activatable Fluorescent Probe