Endoscopic submucosal dissection with the pulley method for early-stage gastric cancer (with video) - 12/08/11
Reprint requests: Peng-Jen Chen, MD, Division of Gastroenterology, Tri-Service General Hospital, No. 325, Sec. 2, Chenggong Road, Neihu District, Taipei City 114, TaiwanRésumé |
Background |
Using EMR techniques, physicians frequently remove tumors >15 mm by piecemeal resection, which is associated with an increased rate of disease recurrence and difficulty in histologically evaluating the specimen. Endoscopic submucosal dissection (ESD) of early-stage gastric cancer improves the rate of successful en bloc resection, but it is associated with more complications, such as bleeding and perforation, than conventional EMR.
Objective |
To describe a simple technique that uses the pulley method to facilitate ESD procedures in the excision of large early-stage gastric cancers.
Design |
Case series.
Setting |
Tertiary medical center in Taiwan.
Patients and Methods |
Eleven patients with early-stage gastric cancers or adenomas >20 mm underwent ESD.
Interventions |
The pulley method with standard clips and dental floss was used to provide traction to improve visualization of the dissection plane during ESD.
Main Outcome Measurement |
Proportion with complete en bloc resection.
Results |
En bloc resection of the lesion was achieved in 11 patients. No perforation or emergent surgery was noted.
Limitations |
One endoscopist performed all procedures, and only 11 patients were studied in an uncontrolled manner.
Conclusions |
The pulley method seems to facilitate en bloc ESD of early-stage gastric cancers >20 mm.
Le texte complet de cet article est disponible en PDF.Abbreviation : ESD
Plan
| DISCLOSURE: All authors disclosed no financial relationships relevant to this publication. |
Vol 73 - N° 1
P. 163-167 - janvier 2011 Retour au numéro
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