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Endoscopy 2001; 33(8): 709-718
DOI: 10.1055/s-2001-16224
Review

© Georg Thieme Verlag Stuttgart · New York

Endoscopic Mucosal Resection

B. J. Rembacken 1 , T. Gotoda 2 , T. Fujii 2 , A. T. R. Axon 1
  • 1 Centre for Digestive Diseases, The General Infirmary at Leeds, United Kingdom
  • 2 National Cancer Centre, Tokyo, Japan
Further Information

Publication History

Publication Date:
31 December 2001 (online)

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We are now finding more malignancies in their early stages than previously. Attempts to ablate these lesions are difficult and do not provide the histological information required to decide on further treatment. Surgery is difficult to justify, as only a minority of lesions are associated with lymph node metastases and lesions may not become clinically relevant within the lifetime of an elderly patient. Endoscopic mucosal resection allows cancers to be resected at minimal cost, morbidity and mortality. It is also the most reliable investigation when assessing lesions which are suspicious for containing early cancer. After endoscopic removal, histological assessment of depth of penetration and a search for invasion into lymphatics or venules allows the risk of microscopic lymph node metastases to be predicted. The risk of developing metastatic disease can then be balanced against the risks of surgery in view of the patient’s age and health.

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B. Rembacken, M.D. 

Centre for Digestive Diseases
The General Infirmary at Leeds

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