Stellenwert der endoskopischen Techniken beim Kolonkarzinom – von der Prävention bis zur Therapie

Background Due to technical progress and increasing endoscopic expertise, endoscopic resection has gained importance for selected lesions even in the presence of early colorectal cancer. Objective Possibilities of endoscopic resection of early colorectal cancer and the limitations are explained. Material and methods Endoscopic dignity assessment and resection methods as well as the contribution to the diagnostics and treatment of early colorectal cancer are presented and discussed on the basis of guideline recommendations and the current study situation. Results Selected early colorectal cancer can be endoscopically resected with curative intent. The correct preinterventional selection of lesions based on endoscopic classification systems is important. If high-risk histological criteria are present, surgical resection with lymph node dissection should follow. Conclusion Endoscopic dignity assessment and resection require a high level of expertise and should therefore be performed at centers with high case numbers, e.g. over 50 endoscopic submucosal dissections (ESD) per year. Technical developments, such as endoscopic full thickness resection (eFTR) may further increase the value of endoscopic treatment in early colorectal cancer even after pretreatment but overall a broader database is still needed.