By Norio Fukami
This quantity educates physicians at the uncomplicated wisdom of ESD, from indication of this system to assessing suitability and technical features of every very important step. The textual content is dependent to lead readers to appreciate the foundations, together with heritage, why ESD was once designed and constructed, symptoms, in addition to the best way to evaluation lesions and practice real approaches. considerable images and diagrams illustrate the foremost issues and advertise “pattern recognition”. The textual content additionally introduces gastroenterologists to early gastrointestinal lesions, that have no longer been well-known in scientific perform for a few years. to help within the therapy technique of ESD, hugely useful details is equipped, separated by means of diversified anatomical destinations, in addition to administration of problems. the amount can also be observed by way of an internet video library.
Written by way of specialists in Asian international locations with monstrous adventure with this system, in addition to specialists from the united states, South the US, and Europe, Endoscopic Submucosal Dissection: rules and Practice offers a big reference for gastroenterologists and surgeons on ESD.
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Extra resources for Endoscopic Submucosal Dissection: Principles and Practice
1988;34:209 (abstr). 4 Role of EUS on Preoperative Staging of Gastric Cancer for ESD 17. Andriulli A, Reccina S, De Angelis C, et al. Endoscopic ultrasonographic evaluation of patients with biopsy negative gastric linitis plastica. Gastrointest Endosc. 1990;36:611–5. 18. Caletti G, Ferrari A, Bocus P, et al. Endoscopic ultrasonography in gastric lymphoma. In: Sivak MV (ed), 10th International Symposium on Endoscopic ultrasonography, Cleveland, OH, October 1995, pp. 119–25 (suppl). 19. Lightdale CJ, Botet JF, Kelsen DP, et al.
Indications of EUS for Gastric Cancer Local Staging EUS is the most accurate method for local staging of gastric cancer [13, 19–31]. The clinical utility of EUS depends on whether preoperative assessment of local tumor extent will change the 4 Role of EUS on Preoperative Staging of Gastric Cancer for ESD 29 Fig. 1 Three-dimensional endoscopic ultrasonography (3D-EUS). (a) Driving unit. (b) 3D-EUS probe. (c) 3D-EUS system Fig. 2 Principle of 3D-EUS choice of therapeutic procedure. That is, several alternatives are now available for the treatment of both early and advanced gastric cancers.
Probably, studies with EUS included more early stages, and therefore, we cannot make conclusions on this issue. Anyway, EUS, abdominal US, MDCT, MRI, and FDG-PET cannot reliably be used to confirm or exclude the presence of lymph node metastasis. It is very difficult to detect lymph node metastasis in T1, because only a very small percentage of T1a and about 15 % of T1b have only one or two metastatic lymph nodes. However, the reliable accuracy of EUS for lymph node diagnosis in T1 is of critical importance in evaluating whether local endoscopic treatment of early gastric cancer is suitable or not.