Zusammenfassung
Um das Risiko für Intervallkrebs nach Koloskopie zu minimieren, müssen wir bei Vorsorgekoloskopie die Detektion von kleinen (<10 mm) und minutiösen (<5 mm) flachen Neoplasien und unauffälligen lateralspreading Tumoren (LST) verbessern sowie die Unterscheidung zwischen oberflächlich oder tief submukosal invasiven Karzinomen. Derzeit erzielt die endoskopische En-bloc-Resektion außerhalb Ostasiens zu geringe kurative Resektionsraten, weil tief sm2–3 invasive kolorektale Karzinomläsionen nicht treffsicher ausgeschlossen werden. Daher konzentrieren wir uns auf die endoskopische Unterscheidung zwischen benignen Läsionen gegenüber malignen Neoplasien sowie oberflächlichen gegenüber tief submuköse invasiven (sm2–3) kolorektalen Frühkarzinomen; beide Unterscheidungen sind erforderlich, um die Differentialindikationen für endoskopische En-bloc-Resektion oder chirurgische Resektion akkurat zu stellen.
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Danksagung
Wir danken Dr. Toshio Uraoka, aus Gunma, Japan für die Bilder der pit patters (Abb. 11.2 a–e), Dr. Tsuneo Oyama aus Nagano, Japan, für die Bereitstellung einiger Fälle und Dr. Daniel Neureiter und Dr. Tobias Kiesslich aus Salzburg, Österreich, für den Beitrag zur Histologie.
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Wagner, A., Maehata, T., Berr, F., Yahagi, N. (2023). Kolorektum: Mukosaneoplasien. In: Berr, F., Oyama, T., Ponchon, T., Yahagi, N. (eds) Atlas Frühkarzinome des Gastrointestinaltrakts. Springer, Cham. https://doi.org/10.1007/978-3-031-25623-3_11
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