胃と腸57巻11号

2022年10月発行

今月の主題 食道癌診療トピックス2022 主題 食道扁平上皮癌をめぐるトピックス

全周切除後の狭窄予防法

著者： 門田智裕¹ 砂川弘憲¹ 中條恵一郎¹ 村野竜朗¹ 新村健介¹ 池松弘朗¹ 矢野友規¹

所属機関： ¹国立がん研究センター東病院消化管内視鏡科

ページ範囲：P.1404 - P.1412

要旨●内視鏡治療技術の進歩により広範囲な食道表在癌に対して内視鏡粘膜下層剝離術（ESD）が選択されるようになってきている．広範囲な食道表在癌ESD後には，食道狭窄を来すことが知られており，ステロイド局注・内服療法を中心とした狭窄予防法が確立してきている．それに伴い，全周性食道表在癌に対してもESDが選択されるようになり，各施設より全周性食道表在癌に対する狭窄予防法の工夫について報告されている．しかし，依然ESD後の狭窄割合は高く，難治性狭窄となりやすい．したがって，確立された狭窄予防法がないのが現状である．また，ESD後に非治癒となり追加治療を検討する必要がある場合も多いため，ESDの選択には慎重になる必要がある．

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