Endoskopische Strategien zur minimal-invasiven Therapie

Zusammenfassung

Durch die Verbesserung der Detektionsraten früher Neoplasien im GI-Trakt können zunehmend Frühkarzinome und deren prämalignen Vorstufen endoskopisch reseziert werden. Die endoskopische Piecemeal-Resektion (EMR) stellt dabei unverändert den Standard für die endoskopische Resektion großer breitbasiger kolorektaler Adenome dar. Kappenassistierte EMR-Verfahren zeigen exzellente Langzeitergebnisse in der Therapie des neoplastischen Barrett-Ösophagus. Für gastrointestinale Frühkarzinome größer als 2 cm ist die endoskopische Submukosadissektion (ESD) das endoskopische Therapieverfahren der Wahl. Der Stellenwert der Vollwandresektion in der endoskopischen Tumortherapie bleibt abzuwarten.

Abstract

Due to higher detection rates of early gastrointestinal neoplasia endoscopic resection of early GI cancers or precancerous lesions is increasing. Endoscopic piece-meal resection (EMR) remains the standard technique for the endoscopic resection of large sessile colorectal adenomas. Cap-assisted EMR techniques show excellent long-term results in the endoscopic therapy of neoplastic Barrett’s esophagus. For the endoscopic resection of early gastrointestinal cancers of more than 2 cm endoscopic submucosal dissection (ESD) is the method of choice. The value of endoscopic full thickness resection in the therapy of GI tumors remains to be seen.

Schlüsselwörter

gastrointestinale Tumoren - endoskopische Therapie - endoskopische Mukosaresektion - endoskopische Submukosadissektion - Vollwandresektion

Keywords

gastrointestinal tumors - endoscopic therapy - endoscopic mucosal resection - endoscopic submucosal dissection - full-thickness resection

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