초단분절 바렛식도에서 발생한 식도 선암의 내시경 점막하 박리술 1예 = A Case of Endoscopic Submucosal Dissection for Esophageal Adenocarcinoma Arising from Ultrashort-Segment Barrett’s Esophagus

다국어 초록 (Multilingual Abstract)

Barrett’s esophagus is defined as the replacement of normal squamous epithelium of distal esophagus with specialized columnar epithelium. This condition is considered to be a premalignant lesion of esophageal adenocarcinoma. Barrett’s esophagus is classified into long-segment (≥3 cm in length) and short-segment (＜3 cm in length). Detection of the former is more difficult. Adenocarcinomas arising from short-segment Barrett’s esophagus are uncommon in Korea. Barrett’s adenocarcinoma restricted to the mucosa can be treated by endoscopic mucosectomy. In recent years, endoscopic submucosal dissection for early esophageal cancer has been extensively applied because it is a reliable method to achieve en bloc resection. In this paper, we report a case of esophageal adenocarcinoma arising from ultrashort-segment Barrett’s esophagus, which was successfully resected by endoscopic submucosal dissection.

국문 초록 (Abstract)

바렛 식도는 위식도 접합부위의 편평 상피 세포가 원주 상피 세포로 이행된 부위를 일컬으며 최근 증가하고 있는 식도 선암의 주요 원인이다. 바렛 식도는 편평 원주 상피 접합부가 위식도 접합부 상방으로 3 cm 이상 상승된 장분절 바렛 식도와 3 cm 미만으로 상승된 단분절 바렛 식도로 분류한다. 장분절 바렛 식도에서 악성변화가 더 빈번하나 바렛 식도의 길이에 관계없이 선암의 발생이 가능하다. 최근 조기에 진단되어 점막에 국한된 식도 선암에 대해 내시경적 치료를 통한 좋은 결과를 얻고 있다. 내시경 치료 중 점막하 박리술을 통해 국소 재발을 보다 효과적으로 낮추고 종양의 완전 절제가 가능하게 되었다. 저자들은 바렛 식도 중에서도 초단분절 바렛 식도에서 기원한 식도 선암을 내시경 점막하 박리술을 통해 성공적으로 치료한 증례를 경험하여 문헌 고찰과 함께 보고한다.

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