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Frühes Ösophaguskarzinom: Pro endoskopische Resektion

Early esophageal cancer. pro-endoscopic resection

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Zusammenfassung

In zahlreichen Publikationen mit weit mehr als 1000 Patienten konnte gezeigt werden, dass die endoskopische Therapie von Ösophagusfrühkarzinomen eine effektive und sichere Therapie darstellt. Eine Kombination aus endoskopischer Resektion (ER) von Barrett-Frühkarzinomen mit anschließender Ablation der nichtneoplastischen Barrett-Schleimhaut konnte die Rate an metachronen Neoplasien oder Rezidiven signifikant senken, sodass eine Langzeitkuration in mehr als 95% der Patienten möglich ist. Im Vergleich zur Ösophagusresektion ist die endoskopische Therapie nur mit einer sehr niedrigen Rate schwerer Komplikationen vergesellschaftet, therapiebezogene Todesfälle treten nahezu nie auf. Aus den genannten Gründen wird heute die ER als Therapie der 1. Wahl in zahlreichen internationalen Leitlinien empfohlen. Die Ösophagusresektion stellt beim mukosalen Ösophaguskarzinom nur noch eine Reservetherapie dar.

Abstract

In several publications including more than 1,000 endoscopically treated patients it could be demonstrated that endoscopic treatment of early esophageal cancer is effective and safe. A combination of endoscopic resection (ER) of early Barrett’s neoplasia followed by ablation of the remaining non-dysplastic Barrett’s mucosa was able to significantly reduce the rate of recurrence and metachronous neoplasia. Long-term complete remission rates of more than 95% can be achieved. Compared to esophagectomy, endoscopic treatment has only a very low complication rate and almost no mortality. Therefore, ER is the treatment of choice and recommended by several international guidelines. Esophageal resection only plays a minor role in patients with early esophageal cancer.

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  1. Innere Medizin 2, HSK Wiesbaden, Ludwig-Erhard-Str. 100, 65199, Wiesbaden, Deutschland

    O. Pech & C. Ell

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  1. O. Pech
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  2. C. Ell
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Correspondence to O. Pech.

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Pech, O., Ell, C. Frühes Ösophaguskarzinom: Pro endoskopische Resektion. Chirurg 82, 490–494 (2011). https://doi.org/10.1007/s00104-010-2059-3

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