부산대학교 도서관

Endoscopic resection is the standard therapy for early esophageal cancer in the epithelium and lamina propria, and ensures a high radical cure rate. However, ESD is difficult to perform when the lesion is located in an esophageal diverticulum. Esophageal diverticula are divided into three classes: Zenker, Rokitansky, and supradiaphragmatic. Zenker and supradiaphragmatic diverticula are pseudodiverticula; the muscularis propria has defects, and the location of these pseudodiverticula makes it difficult to perform ESD. Thus, ESD for tumors in these diverticula should not be attempted. On the other hand, the Rokitansky diverticulum is a true diverticulum. However, the muscularis propria is frequently thin or defective due to chronic inflammation. Therefore, ESD for Rokitansky diverticulum tumors poses a high risk for perforation. Examination of the muscularis propria is required to determine the safety of performing ESD. Thus, if thinness or defects of the muscularis propria are detected, surgery, chemoradiation therapy, or radiation therapy should be selected instead of ESD.