Endoscopic submucosal dissection with internal traction for early gastric cancer (with video) - 23/08/11
Reprint requests: You-Chen Chao, MD, Division of Gastroenterology, Tri-Service General Hospital, No. 325, Sec. 2, Chenggong Rd, Neihu District, Taipei City 114, Taiwan.Taipei, Taiwan
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.
Il testo completo di questo articolo è disponibile in PDF.Abbreviations : ESD, IT, PTA-EMR, ST hood
Mappa
Vol 67 - N° 1
P. 128-132 - gennaio 2008 Ritorno al numero
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