Ablative treatment of rectosigmoideal praecanceroses and early cancer

Czech version

Authors: P. Mlkvý ¹; I. Čavarga ²; A. Mateášik ²
Authors‘ workplace: Oddelenie laserovej medicíny Onkologického ústavu sv. Alžbety Bratislava, Slovenská republika, prednosta prof. MUDr. Peter Mlkvý, CSc. ¹; Medzinárodné laserové centrum Bratislava, Slovenská republika, riaditel prof. Ing. František Uherek, CSc. ²
Published in: Vnitř Lék 2011; 57(12): 1034-1037
Category: 70th birthday of prof. MUDr. Petr Dítě, DrSc.

Overview

Endoscopic mucosal resection and piece meal polypectomy are methods of choice in broad based unifocal rectosigmoideal lesions. Thermal ablative modalities are indicated for flat adenomas, lateral spreading tumors and as an adjunct therapeutic modality for incomplete polypectomy. Photodynamic therapy using ALA photosensitiser is effective in the treatment of multifocal lesions either alone or in a combination with thermal ablative techniques. At present “tailored suite” combination of these techniques for each patient according the character of the lesion is considered to be the most effective treatment for rectosigmoideal praecancerous lesions and early cancer.

Key words:
praecancerous lesions – early cancer – resection – ablation – combination techniques

Sources

1. Pleško I, Obšitníková A. Incidencia zhubných nádorov v Slovenskej republike v r. 1999. Národný onkologický register 2002; 37.

2. Piedbois P, Buyse M. Recent meta-analysis in colorectal cancer. Cur Opin Oncol 2000; 12: 362–637.

3. Skibber JM, Minsky PM et al. Cancer of the Colon. 1216–1270. In: Cancer: Principle and Practice in Oncology. New York-London: Lippincot Williams 2000.

4. Tamura I, Ohkawauchi K, Yokohama Y et al. Indications and Techniques for Endoscopic Mucosal Resection in the Lesions of A Colorectal Tumor. Digestive Endoscopy 2003; 15: S39–S43.

5. Deinlein P, Reulbach U, Stolte M et al. Risikofaktoren der lymphogenen Metastasierung von kolorektalen pT1-Karzinomen. Pathologe 2003; 24: 387–393.

6. Dancygier H, Lightdale C. Endosonography in Gastroenterology. Stuttgart: Thieme 1998: 248–251.

7. Díťě P, Špičák J, Bureš J et al. Nové trendy v digestívní endoskopické diegnostice a léčbě. Praha: Grada Publishing 2000: 283–287.

8. Rembacken BD, Gotoda T, Fuji Z. Endoscopic mucosal resection. Endoscopy 2003; 33: 709–718.

9. Sakal P, Filho FM, Irya K et al. An endoscopic technique for resection of small gastrointestinal carcinomas. Gastrointest Endosc 1996; 44: 65–68.

10. Feitoza AB, Gostout CJ, Burgart LJ et al. Hydroxypropyl methylcellulose: A better submucoseal fluid cushion for endoscopic mucosal resection. Gastrointest Endosc 2003; 57: 41–47.

11. Mlkvý P, Makovník P, Májek J et al. Laserová a fotodynamická liečba kolorektálneho karcinómu. Abstrakt III, VDOG 2002.

12. Farin G, Grund KE. Technology of argon plasma coagulation with particular regard to endoscopic application. Endoscop Surg Allied Technol 1994; 2: 71–77.

13. Ginsberg GG, Barkun AN, Bosco JJ et al. The argon plasma coagulation: technology status evaluation report. Gastroint Endoscopy 2002; 55: 807–810.

14. Bown SG, Lovat LB. The biology of photodynamic therapy in the gastrointestinal tract. Gastrointest Endosc Clin N Am 2000; 10: 533–550.

15. Mlkvý P, Messmann H, Regula J et al. Photodynamic therapy for gastrointestinal tumours using three photosensitisers: ALA induced PP IX, Photofrin and mTHPc – A Pilot Study. Neoplasma 1998; 45: 157–161.

16. Schollmerich JW, Schmiegel H. Leitfaden kolorektales Karzinoms. Uni med Bremen-London-Boston 2000: 147–167.