Endoscopic submucosal dissection with internal traction for early gastric cancer (with video).

Abstract:

BACKGROUND:EMR techniques have high success rates for treating small lesions of the upper-GI tract; however, tumors larger than 15 mm are frequently removed by piecemeal resection, which is associated with an increased rate of disease recurrence and difficulty in histologically evaluating the specimen. OBJECTIVE:To describe a simple technique of using internal traction to facilitate endoscopic submucosal dissection (ESD) procedures in the excision of large, early gastric cancers. DESIGN:Case series. SETTING:A tertiary medical center in Taiwan. PATIENTS AND METHODS:Eight patients with early gastric cancers larger than 20 mm underwent ESD. INTERVENTIONS:A standard hemoclip modified with surgical suture was used to provide traction to improve visualization of the dissection plane during ESD. MAIN OUTCOME MEASUREMENTS:Proportion with complete en bloc resection. RESULTS:En bloc resection of the lesion was achieved in 8 patients. One patient underwent additional surgery because an adequate safe margin was not obtained by ESD. LIMITATIONS:One endoscopist performed all procedures, and only 8 patients were studied in an uncontrolled manner. CONCLUSIONS:The internal traction method appears to facilitate en bloc ESD of early gastric cancers larger than 20 mm.

journal_name

Gastrointest Endosc

authors

Chen PJ,Chu HC,Chang WK,Hsieh TY,Chao YC

doi

10.1016/j.gie.2007.07.021

subject

Has Abstract

pub_date

2008-01-01 00:00:00

pages

128-32

issue

1

eissn

0016-5107

issn

1097-6779

pii

S0016-5107(07)02375-9

journal_volume

67

pub_type

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