[Endoscopic Interventional Treatment of Precancerous Lesions and Early Carcinoma of the Esophagus - Criteria and Techniques of Local Ablation and Resection]. / Endoskopisch interventionelle Behandlung von Malignitätsvorstufen und des Frühkarzinomes des Ösophagus.

ABSTRACT

Endoscopic Interventional Treatment of Precancerous Lesions and Early Carcinoma of the Esophagus - Criteria and Techniques of Local Ablation and Resection Abstract. Early carcinomas of the esophagus can safely be resected endoscopically and interventionally under very strict conditions (ER). In contrast to ablative procedures (radiofrequency ablation, cryo-ablation, argon plasma coagulation, photodynamic therapy), which can only be recommended for Barrett's or low-grade dysplasia, ER - which is called EMR (endoscopic mucosal resection in adenocarcinoma) or more in-depth ESD (endoscopic submucosa dissection in squamous cell carcinoma) - a defined, histologically examinable preparation. This is required starting with high-grade dysplasia, since 50% of patients with biopsy-confirmed high-grade dysplasia after ER already have an invasive carcinoma in the specimen. This diagnostic gap is thus also closed with an interventional ER. ER is therefore an option for high-grade dysplasia in Barrett's, carcinoma in situ (Cis) and conditionally in T1a (adeno- and squamous cell carcinoma) and early T1b tumors (adenocarcinoma).