Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
© Copyright 2017. Korean Association for the Study of Intestinal Diseases.
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Factor | Type of tumor |
---|---|
Preprocedural assessment of histology | Adenoma, low-grade dysplasia |
Adenoma, high-grade dysplasia | |
Mucosal cancer | |
SM invading cancer, shallow | |
SM invading cancer, massive looking | |
Endoscopic morphology | LST-G homogeneous type |
LST-G nodular mixed type | |
LST-NG flat elevated type | |
LST-NG pseudo-depressed type | |
Presence of depression or ulcer | Any tumor with IIc area |
Any tumor with ulcer | |
Pit pattern (Kudo classification) | Type II |
Type III or IV | |
Type V-I (irregular) | |
Type V-N (nonstructural) | |
NBI pattern (Sano-Emura classification) | Type I |
Type II (thick capillary pattern) | |
Type III-a (nonuniform irregular capillary pattern) | |
Type III-b (avascular pattern) | |
Nonlifting sign (benign fibrosis looking) | Partially nonlifted lesions with benign fibrosis |
Severely nonlifted lesions with benign fibrosis | |
Nonlifting sign (shallow SM invasion is suspected) | Shallow SM-invasive cancer suspected, and partially nonlifted |
Shallow SM-invasive cancer suspected, and severely nonlifted | |
Nonlifting sign (massive SM invasion is suspected) | Massive SM-invasive cancer suspected, and partially nonlifted |
Massive SM-invasive cancer suspected, and severely nonlifted | |
Special situation | Sporadic localized tumors in chronic inflammation |
Local residual early cancer after endoscopic resection |
SM, submucosal; LST-G, laterally spreading tumor granular; LST-NG, laterally spreading tumor nongranular; NBI, narrow band imaging.
Question | Answer (%) | |
---|---|---|
Is the use of magnification endoscopy essential to determine whether ESD is indicated? | 1. No (HD level endoscopy is enough) | 27.3 |
2. Rarely (<10%) | 63.6 | |
3. Sometimes (10%–50%) | 0 | |
4. Usually (>50%) | 9.1 | |
5. Almost always (>90%) | 0 | |
Is the use of NBI essential to determine whether ESD is indicated? | 1. No (HD level endoscopy is enough) | 15.4 |
2. Rarely (<10%) | 23.1 | |
3. Sometimes (10%–50%) | 30.8 | |
4. Usually (>50%) | 23.1 | |
5. Almost always (>90%) | 7.7 | |
Is the use of EUS essential to determine whether ESD is indicated? | 1. No (HD level endoscopy is enough) | 23.1 |
2. Rarely (<10%) | 38.5 | |
3. Sometimes (10%–50%) | 38.5 | |
4. Usually (>50%) | 0 | |
5. Almost always (>90%) | 0 | |
Is the use of EUS essential to determine whether ESD is indicated? | 1. Rectal EUS only | 42.9 |
2. Both colon and rectal EUS | 57.1 | |
Practically, which method do you most commonly use to determine whether you try ESD or not? | 1. Gross morphology | 60.0 |
2. Magnifying colonoscopy | 0 | |
3. NBI | 0 | |
4. EUS | 0 | |
5. Nonlifting sign | 40.0 | |
Ideally, what is the most accurate method for evaluating the depth of invasion, in your opinion? | 1. Gross morphology | 23.1 |
2. Magnifying colonoscopy | 30.8 | |
3. NBI | 15.4 | |
4. EUS | 30.8 | |
5. Nonlifting sign | 0 |
ESD, endoscopic submucosal dissection; HD, high definition; NBI, narrow band imaging.
SM, submucosal; LST-G, laterally spreading tumor granular; LST-NG, laterally spreading tumor nongranular; NBI, narrow band imaging.
ESD, endoscopic submucosal dissection; HD, high definition; NBI, narrow band imaging.