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논문KCI 등재

Clinical Practice Guideline for Endoscopic Resection of Early Gastrointestinal Cancer

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주제분류내과학

초록

Although surgery was the standard treatment for early gastrointestinal cancers, endoscopic resection is now a standard treatment forearly gastrointestinal cancers without regional lymph node metastasis. High-definition white light endoscopy, chromoendoscopy, andimage-enhanced endoscopy such as narrow band imaging are performed to assess the edge and depth of early gastrointestinal cancersfor delineation of resection boundaries and prediction of the possibility of lymph node metastasis before the decision of endoscopicresection. Endoscopic mucosal resection and/or endoscopic submucosal dissection can be performed to remove early gastrointestinalcancers completely by en bloc fashion. Histopathological evaluation should be carefully made to investigate the presence of risk factorsfor lymph node metastasis such as depth of cancer invasion and lymphovascular invasion. Additional treatment such as radical surgerywith regional lymphadenectomy should be considered if the endoscopically resected specimen shows risk factors for lymph nodemetastasis. This is the first Korean clinical practice guideline for endoscopic resection of early gastrointestinal cancer. This guidelinewas developed by using mainly de novo methods and encompasses endoscopic management of superficial esophageal squamous cellcarcinoma, early gastric cancer, and early colorectal cancer. This guideline will be revised as new data on early gastrointestinal cancer arecollected.

Abstract

Although surgery was the standard treatment for early gastrointestinal cancers, endoscopic resection is now a standard treatment forearly gastrointestinal cancers without regional lymph node metastasis. High-definition white light endoscopy, chromoendoscopy, andimage-enhanced endoscopy such as narrow band imaging are performed to assess the edge and depth of early gastrointestinal cancersfor delineation of resection boundaries and prediction of the possibility of lymph node metastasis before the decision of endoscopicresection. Endoscopic mucosal resection and/or endoscopic submucosal dissection can be performed to remove early gastrointestinalcancers completely by en bloc fashion. Histopathological evaluation should be carefully made to investigate the presence of risk factorsfor lymph node metastasis such as depth of cancer invasion and lymphovascular invasion. Additional treatment such as radical surgerywith regional lymphadenectomy should be considered if the endoscopically resected specimen shows risk factors for lymph nodemetastasis. This is the first Korean clinical practice guideline for endoscopic resection of early gastrointestinal cancer. This guidelinewas developed by using mainly de novo methods and encompasses endoscopic management of superficial esophageal squamous cellcarcinoma, early gastric cancer, and early colorectal cancer. This guideline will be revised as new data on early gastrointestinal cancer arecollected.

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