조기위장관암 내시경 치료 임상진료지침

• Published in: The Korean journal of helicobacter and upper gastrointestinal research pp. 117 - 145
• Main Authors: 박찬혁, 양동훈, 김정욱, 김지현, 민양원, 이시형, 배정호, 정현수, 최기돈, 박준철, 이혁, 곽민섭, 김번, 이현정, 이혜승, 최미영, 박동아, 이종열, 변정식, 박찬국, 조주영, 이수택, 전훈재
• Format: Journal Article
• Language: Korean
• Published: 대한상부위장관ㆍ헬리코박터학회 01-06-2020
• Subjects: 내과학
• ISSN: 1738-3331; 2671-826X
• DOI: 10.7704/kjhugr.2020.0023

Although surgery was the standard treatment for early gastrointestinal cancers, endoscopic resection is now a standard treatment for early gastrointestinal cancers without regional lymph node metastasis. High-definition white light endoscopy, chromoendoscopy, and image-enhanced endoscopy such as narrow band imaging are performed to assess the edge and depth of early gastrointestinal cancers for delineation of resection boundaries and prediction of the possibility of lymph node metastasis before the decision of endoscopic resection. Endoscopic mucosal resection and/or endoscopic submucosal dissection can be performed to remove early gastrointestinal cancers completely by en bloc fashion. Histopathological evaluation should be carefully made to investigate the presence of risk factors for lymph node metastasis such as depth of cancer invasion and lymphovascular invasion. Additional treatment such as radical surgery with regional lymphadenectomy should be considered if the endoscopically resected specimen shows risk factors for lymph node metastasis. This is the first Korean clinical practice guideline for endoscopic resection of early gastrointestinal cancer. This guideline was developed by using mainly de novo methods and encompasses endoscopic management of superficial esophageal squamous cell carcinoma, early gastric cancer, and early colorectal cancer. This guideline will be revised as new data on early gastrointestinal cancer are collected. KCI Citation Count: 0