By Frieder Berr, Tsuneo Oyama, Thierry Ponchon, Naohisa Yahagi
Early Neoplasias of the Gastrointestinal Tract: Endoscopic prognosis and healing Decisions is an replace of the present criteria and most modern abilities in diagnostic endoscopy for neoplastic lesions of the higher and reduce gastrointestinal tract. the quantity defines recommendations for detection and endoscopic evaluate of small and minute early cancers and precursor lesions, together with the endoscopic and endosonographic standards for submucosal invasiveness. The publication presents the data in novel magnifying endoscopic research of early neoplasias primary to differential indication on snare mucosectomy, endoscopic submucosal dissection, or surgical/laparoscopic full-wall resection. Differential symptoms and contraindications for every process also are specified.
Comprehensive and authored through the world over popular specialists within the box, Early Neoplasias of the Gastrointestinal Tract: Endoscopic prognosis and healing Decisions is a helpful source that might increase the diagnostic talents of rookies in addition to skilled endoscopists in endoscopic submucosal dissection.
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Most of them are well- or moderately differentiated squamous cell carcinomas (grading G1 or G2), but due to the thin submucosal layer rich in lymphatic vessels, the risk of early local spread is high . 5 mm from the margin) onto a cork or rubber board, and immersed in 4 % buffered formaldehyde solution. It is recommended that specimens are cut into slices 2 mm thick for subserial microscopic examination . 1) [1–3]. Quantitative micrometre (μm) measurement are reported from the lower limit of the muscularis mucosae, when the position of the muscularis mucosae can be determined precisely in the area of the tumour invasion.
ESD – expanded indications SCC type 0-II (HGIN, G1, G2) slightly invasive (m3, sm<200 μm), any sizea, clinical N 0. Barrett adenocarcinoma type 0-II (HGIN or G1, G2), mucosal (≤ MM), clinical N 0. (C) Colorectum ESD indications (preliminary criteria)b [1, 7, 29, 30, 33] Any neoplasias >20 mm in diameter without signs of deep submucosal invasion, indicative for en bloc resection and unsuitable for EMR en bloc: LST-granular type (villous adenoma +/− HGIN)c LST-nongranular type Mucosal carcinoma (HGIN, G1 or G2) or superficially sm-invasived Depressed-type neoplasias (0-IIc) Neoplasias type 0-I or 0-II with pit pattern type VI (irregular) Sporadic localized neoplasias in chronic ulcerative colitis Colorectal carcinoids of diameter <20 mm [EMR, when diameter <10 mm] a Increased risk for stricture formation, when ESD extends for ≥70 % of circumference b Japanese guideline criteria pending c LST-granular type may also be resected in piecemeal fashion, the larger nodule resected first  d sm1 invasion of ≤1,000 μm standardized until 2012 because of associated technical difficulties, such as winding thin wall, haustral folds, less stable position of the endoscope in flexures, peristalsis and respiratory movements.