Endoskopische Therapie früher Neoplasien der Speiseröhre

In recent years, radical oesophageal resection could have been replaced by endoscopic therapy in the treatment of early oesophageal cancer. The rationale behind endoscopic treatment of early oesophageal neoplasia is the fact that neoplasias limited to the mucosal layer have a very low risk for lymph node or distant metastasis and therefore local endoscopic removal of the neoplastic lesion is curative. In contrast, radical oesophageal resection is associated with a mortality rate of 3-20 % and a morbidity rate of 40-50 %. For endoscopic treatment, mainly photodynamic therapy (PDT) and endoscopic resection (ER) are used. Both methods have demonstrated excellent results regarding complete remission rates with a very low complication rate of about 3 %. The important advantage of ER in contrast to PDT is the fact that a histological specimen is obtained that can be evaluated by the pathologist regarding infiltration depth and status of the margins (R0-status).

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