152 153 Intestinal Disease Meeting Berlin 2006 - Dr. Falk Pharma ...

Endoscopy – It also has therapeutic
value
Modern endoscopy’s role is not limited to diagnosing
disorders. As N. Soehendra (Hamburg)
noted, it also has therapeutic value. Examples
include endoscopic mucosal resection and
endoscopic submucosal dissection (figure 7),
as well as treatment of pancreatic abscesses and
clipping.
Especially in the therapy of early carcinomas of
the esophagus and stomach, endoscopic mucosal
resection can represent an attractive alterna-
Fig. 7
N. Soehendra
I Endoscopic submucosal dissection (N. Soehendra, Hamburg)
Congress Short Report Falk Symposium 152
tive to conventional surgery. The endoscopic excision
of circumscript malignant lesions is associated
with long-term results comparable to those
of conventional surgery. “There is,” N. Soehendra
observed, “a significantly lower morbidity and
this means increased quality of life for the patients.”
Based on this positive experience the range of
indications for endoscopic methods has become
broader. Limitations include the depth of infiltration
and the size of the tumor. Tumors that are restricted
to the topmost submucosal layer and do
not exceed 30 mm in diameter can be removed
completely using the technique of submucosal
dissection. If in certain cases it is necessary to
remove long mucosal segments, N. Soehendra
noted that the operator may use a “suck-andcut”
technique or, where more suitable, ligatures
or the so-called “piecemeal” technique can be
used in order to successively remove neighboring
areas of mucosa (figure 8).
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