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Marc BARTHET

Hôpital Universitaire Nord
Marseille, Франция
MD, PhD
59 лайков
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Staging before endoscopic resection: EMR and ESD
Pre-procedural planning before any endoscopic resection requires the assessment of the lesion. The main criteria which need to be assessed are the following:
- depth of invasion of the lesion;
- lymph node metastasis;
- lateral spread of the tumor;
- pit pattern.
Routine endoscopy is used to assess tumor size. Tumors can be staged with the use of many classifications, and notably the Paris classification.
High-frequency (≥20MHz) endoscopic ultrasonography (EUS) produces an image of the mucosal wall comprising nine separate layers differentiated by their echogenicity. Careful examination of the depth of lesion penetration into the mucosal and submucosal layers is used to determine the risk of lymph node metastases with a greater precision.
Pit pattern can be evaluated by means of magnification on endoscopy.
Kudos classification is used.
Type I: roundish pits
Type II: stellar or papillary pits
Type III S: small roundish or tubular pits (smaller than type I pits)
Type III L: large roundish or tubular pits (larger than type I pits)
Type IV: branch-like or gyrus-like pits
Type V: non-structured pits
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3 лет назад
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16:59
Staging before endoscopic resection: EMR and ESD
Pre-procedural planning before any endoscopic resection requires the assessment of the lesion. The main criteria which need to be assessed are the following:
- depth of invasion of the lesion;
- lymph node metastasis;
- lateral spread of the tumor;
- pit pattern.
Routine endoscopy is used to assess tumor size. Tumors can be staged with the use of many classifications, and notably the Paris classification.
High-frequency (≥20MHz) endoscopic ultrasonography (EUS) produces an image of the mucosal wall comprising nine separate layers differentiated by their echogenicity. Careful examination of the depth of lesion penetration into the mucosal and submucosal layers is used to determine the risk of lymph node metastases with a greater precision.
Pit pattern can be evaluated by means of magnification on endoscopy.
Kudos classification is used.
Type I: roundish pits
Type II: stellar or papillary pits
Type III S: small roundish or tubular pits (smaller than type I pits)
Type III L: large roundish or tubular pits (larger than type I pits)
Type IV: branch-like or gyrus-like pits
Type V: non-structured pits