Endoskopische Resektion von Frühtumoren im oberen Gastrointestinaltrakt – Diagnose und Therapie früher Neoplasien

Die endoskopische Mukosaresektion und – als ihre Erweiterung – die endoskopische Submukosadissektion haben sich in den letzten Jahren weltweit zunehmend in der Therapie gastrointestinaler Präkanzerosen und Frühkarzinome etabliert. Ist das Frühkarzinom des Barrett–/Ösophagus auf die Mukosa oder im Magen auf das obere Drittel der Submukosa begrenzt und finden sich keine mikrolymphangischen (L +/–) und mikrovenösen (V +/–) Tumorinfiltrationen, ist die endoskopische Resektion als Therapieverfahren der Wahl anzusehen. Sollte sich nach einer endoskopischen Resektion ein höheres Tumorstadium im Sinne einer tieferen Submukosainfiltration diagnostizieren lassen, besteht unverändert die Möglichkeit der chirurgischen Nachresektion, falls der Patient operabel ist.

Endoscopic resection of the mucosa – and its elaborationž endoscopic dissection of the submucosa – have become more and more established on a world–wide scale during the past few years in the treatment of gastro–intestinal precanceroses and early carcinomas. If the early carcinoma of Barrett's esophagus (Barrett's syndrome) is restricted to the mucosa or in the stomach to the upper third of the submucosa and if there are no microlymphangial (L +/–) and microvenous (V +/–) tumourous infiltrations, endoscopic resection must be considered to be the therapy of choice. In case a progressed stage of tumour is diagnosed after an endoscopic resection – the tumour signifying a deeper infiltration of the submucosa – there is always the possibility of subsequent surgical resection, provided the patient's condition permits surgery.

endoscopic resection of the mucosa - endoscopic resection of the submucosa - gastro–intestinal precanceroses - gastro–intestinal early carcinomas - Barrett's syndrome

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