Clinical Endoscopy

  • 제42권2호
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  • Pages.90-93
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  • 2011
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  • 2234-2400(pISSN)
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  • 2234-2443(eISSN)
대한소화기내시경학회 (The Korean Society of Gastrointestinal Endoscopy)
권호 표지

내시경 점막하 박리술 후 점막 고유층에 재발한 조기위암 1예

Local Recurrence of EGC after ESD

  • 이상훈 (가톨릭대학교 의과대학 내과학교실) ;
  • 정진환 (가톨릭대학교 의과대학 내과학교실) ;
  • 송준호 (가톨릭대학교 의과대학 내과학교실) ;
  • 김정호 (가톨릭대학교 의과대학 내과학교실) ;
  • 정대영 (가톨릭대학교 의과대학 내과학교실) ;
  • 김진일 (가톨릭대학교 의과대학 내과학교실) ;
  • 박수헌 (가톨릭대학교 의과대학 내과학교실) ;
  • 김재광 (가톨릭대학교 의과대학 내과학교실)
  • Lee, Sang-Hun (Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Jung, Jin-Hwan (Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Song, Jun-Ho (Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Kim, Jeong-Ho (Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Cheung, Dae-Young (Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Kim, Jin-Il (Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Park, Soo-Heon (Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Kim, Jae-Kwang (Department of Internal Medicine, The Catholic University of Korea College of Medicine)
  • 발행 : 2011.02.27
⟨ 이전 논문 다음 논문 ⟩

초록

내시경 점막 절제술은 미분화 조직 형태의 조기위암에서는 림프절 전이가 상대적으로 높아서 수술의 대체 치료법으로 받아들여지지 않고 있다. 최근 개발된 내시경 점막하 박리술로 큰 점막 병변 혹은 궤양을 동반한 병변의 완전 절제가 가능하나 치료 적응증은 림프절 전이가 없는 조기위암에 한정된다. 만약 림프절 전이의 위험도가 낮은 환자군을 규명한다면 내시경 점막하 박리술이 수술 치료법을 대체할 수 있을 것이다. 또한 내시경 점막하 박리술은 조직의 정확한 평가와 잔존암 및 재발을 예방할 수 있다. 저자들은 미분화 조기위암을 내시경 점막하 박리술로 완전 절제한 후, 림프절 전이를 동반하지 않고 박리술 반흔 조직검사에서 점막 고유층에서 재발한 1예를 경험하였기에 문헌고찰과 함께 이를 보고한다.

Endoscopic mucosal resection is not accepted as an alternative to surgery for treating EGC of the undifferentiated histologic type because of the relatively higher probability of lymph node metastasis with the endoscopic procedure. The recently developed endoscopic submucosal dissection (ESD) techniques have made en-bloc resection of large intramucosal or ulcerated lesions feasible, but the procedure's therapeutic indications are limited to EGC without lymph node metastasis. If we could define a subgroup of patients who have undifferentiated EGC with a low-risk of lymph node metastasis, then the application of ESD would be possible instead of surgery. ESD also allows precise histologic assessment of resected specimens and it may prevent residual disease and local recurrence. We report on a case that poorly differentiated adenocarcinoma was curatively removed by ESD, but cancer recurrence was detected in the lamina propria of the post ESD scar without lymph node metastasis or intraluminal lesions three years after the ESD.

키워드

참고문헌

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