[Endoscopic treatment of gastrointestinal cancers--indication and limitation]

Recently, endoscopic treatments have been applied for the curative treatment of early gastrointestinal cancers and for the palliative treatment of end-stage gastrointestinal cancers. As a curative treatment for early gastric cancers, the endoscopic Nd-YAG laser therapy was initially applied and a satisfactory results were obtained. However, the endoscopic mucosal resection (EMR) is evaluated as the reliable endoscopic treatment for early gastric cancers because curability can be histologically detected by resected specimen. EMR technique is also applied for early esophageal cancers and early flat or depressed colon cancers. EMR-L (EMR with the use of Ligating device) developed by us is mainly practiced in our department. By the use of EMR-L technique. Resectability has been improved compared with 2 channel EMR technique. As the palliation of end-stage gastrointestinal cancers endoscopy recanalization of malignant esophageal stenosis is very effective to improve the patient's QOL. The memorial metallic stent for esophageal stenosis is very useful to keep cavity for a long term after endoscopic recanalization. PEG (percutaneous endoscopic gastrostomy) is also very effective to reduce the symptoms of the patients with peritonitis carcinoma or ileus. In this paper, the present status of curative and palliative endoscopic treatment for gastrointestinal cancers was reported. In recent future, endoscopy will be more widely applied as a less invasive therapeutic procedure for gastrointestinal cancers.