Recent advances in diagnostic endoscopy to detect early-stage upper Gl cancer and therapeutic endoscopy to establish minimally invasive endoluminal treatment

Abstract

Recent advances in diagnostic endoscopy and therapeutic endoscopy of upper gastrointestinal cancer in which present authors have been involved in part were reviewed and summarized in this article. In the field of diagnostic endoscopy a concept of endoscopic, evaluation of tissue atypia was introduced. NBI (narrow-band image) brought us a significant advancement particularly in magnifying endoscopy. IPCL type classification in the esophagus was reviewed. Another advance was the development of endocytoscopy. Ultra-high magnification endoscopy utilizing endocytoscopy realized in vivo observation of living cancer cell. CM (crystal violet and methylene blue) double staining which is expected to be relevant to conventional histological HE staining was newly developed. ECA classification in the esophagus and stomach were introduced. In the field therapeutic endoscopy, ESD (endoscopic submucosal dissection) is a newly developed and established procedure which enables en bloc resection of widely spread mucosal lesions. We designed and reported a triangle-tip knife which enables easy dissection with less experienced hand of the procedure. Those efforts mentioned above are effective to detect early-stage gastrointestinal cancer and to launch a less invasive treatment preserving organ. © 2008 Springer Japan.