조기위장관암 내시경 치료 임상진료지침

• Published in: The Korean journal of gastroenterology Vol. 75; no. 5; pp. 264 - 291
• Main Authors: 박찬혁, Chan Hyuk Park, 양동훈, Dong-hoon Yang, 김정욱, Jong Wook Kim, 김지현, Jie-hyun Kim, Ji Hyun Kim, 민양원, Yang Won Min, 이시형, Si Hyung Lee, 배정호, Jung Ho Bae, 정현수, Hyunsoo Chung, 최기돈, Kee Don Choi, 박준철, Jun Chul Park, 이혁, Hyuk Lee, 곽민섭, Min-seob Kwak, 김번, Bun Kim, 이현정, Hyun Jung Lee, 이혜승, Hye Seung Lee, 최미영, Miyoung Choi, 박동아, Dong-ah Park, 이종열, Jong Yeul Lee, 변정식, Jeong-sik Byeon, 박찬국, Chan Guk Park, 조주영, Joo Young Cho, 이수택, Soo Teik Lee, 전훈재, Hoon Jai Chun
• Format: Journal Article
• Language: Korean
• Published: 대한소화기학회 31.05.2020
• Subjects: Early colorectal cancer; Early gastric cancer; Endoscopic resection; Guideline; Superficial esophageal squamous cell carcinoma; 내과학
• ISSN: 1598-9992; 2233-6869
• DOI: 10.4166/kjg.2020.75.5.264

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, chro-moendoscopy, 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. (Korean J Gastroenterol 2020;75:264-291)