Endoscopic surgery in polyps, adenomas, early stages of cancer of the stomach and colon
Endoscopic surgery for benign and malignant tumors of the esophagus, stomach, duodenum, small intestine and colon is highly effective minimally invasive treatment. The undeniable advantage of endoscopic interventions for the patient is a low-impact nature of the operation, because the access to the pathological formation in the stomach or intestines, doctor performs through natural orifice by using an endoscope, without compromising the integrity of tissues (without cuts). Alternative to endoscopic surgical interventions are open abdominal surgeries with a large incision, the risk of complications and a long period of hospital stay and recovery.
Aside from the obvious benefits to the patient, there is a number of equally important things to the experts: endoscopic surgical methods allow carefully to remove the tumor within healthy tissues, with carrying out further detailed histological study that exactly will answer the question about the nature of the tumor and the radicality of the intervention (e.g. removal of tumors completely). The most effective endoscopic surgeries of polyps, adenomas, early stages of cancer are:
Endoscopic mucosal resection (EMR)
With this type of surgery removes the wall fragment including the mucous membrane. More often are used for small tumors. The main indication for this procedure is early cancer of the gastrointestinal tract (esophagus, stomach, duodenum, small intestine and colon) and benign tumors (polyps, adenomas and others). The operation usually takes 1.5-2 hours, and post-operative period (the time when the patient must remain in the hospital) is from 1 to 3 days. Thus, the period of stay in the hospital is reduced by more than half, as opposed to open surgery. Usually, patients do not feel any discomfort or pain after such operations.
Endoscopic dissection of the submucosal layer (ESD )
Endoscopic dissection of the submucosal layer is an operation to remove a large area of the affected mucosa with neoplasm and of the submucosal layer with its own muscularis mucosa, with special endoscopic techniques. Nowadays, the most successful method of treatment is used even common tumors of the gastrointestinal tract including digestive tract and as flat tumors (LST). This technique allows you to remove completely the tumor and adjacent tissues through an endoscope, avoiding large surgery (open surgery). Before performing endoscopic dissection in order to confirm the diagnosis and localization of the tumor is performed procedure esophagogastroduodenoscopy (EGD) or colonoscopy. Combining it with an endoscopic ultrasound to see the depth of tumor germination, after that the boundaries of resection / dissection are flagged by using thermocoagulation.
With the dissection cancerous area using hydrodissection rises above the submucosa using endoscopic injection followed by special thin instruments tumor is removed by one block with the surrounding tissues. The removed material is sent to the pathomorphological study to determine the nature of the tumors, which determines further patient’s treatment. The main advantage of endoscopic dissection is the ability to remove tumors by single block, regardless of their sizes.