Local treatment of oesophageal cancer

The indications for curative endoscopic resection of oesophageal cancer are as follows: (1) mucosal cancer without gross invasion to the muscularis mucosae; (2) less than 2 cm x 2 cm in size or less than a third of the circumference of the oesophagus; (3) absence of recognizable nodal involvement. In our department, a small transparent cap is attached to the distal part of the forward-viewing endoscope. The snare forceps is passed through the working channel of the endoscope and is opened in the cap. The protruding mucosa is then snared into the cap by the suction mechanism of the endoscope. Endoscopic resection was performed in 40 cases. In all instances a complete response was obtained locally. There were a few post-operative complications. The 5 year survival rate was 95% and no recurrence has been observed.