Endoscopy 2001; 33(3): 221-226
DOI: 10.1055/s-2001-12805
Original Article

© Georg Thieme Verlag Stuttgart · New York

New Endoscopic Treatment for Intramucosal Gastric Tumors Using an Insulated-Tip Diathermic Knife

M. Ohkuwa, K. Hosokawa, N. Boku, A. Ohtu, H. Tajiri, S. Yoshida
  • Division of Digestive Endoscopy and Gastrointestinal Oncology, National Cancer Center Hospital East, Chiba, Japan
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
31. Dezember 2001 (online)

Background and Study Aims: For one-piece resection the conventional technique of endoscopic mucosal resection (EMR) is limited to gastric mucosal tumors of 10 mm or less in size. In this retrospective study, we investigated the efficacy and complications associated with a new EMR method, using an insulated-tip diathermic knife (IT-EMR).

Patients and Methods: In a total of 41 patients gastric mucosal tumors were resected using IT-EMR.

Results: One-piece resection rates were 82 % (14/17) for lesions of 10 mm or less, 75 % (12/16) for those between 11 and 20 mm, and 14 % (1/7) for those of over 20 mm. Complication rates for severe bleeding and perforation were 22 % and 5 %, respectively. With a median follow-up period of 32 months, no recurrence was observed after these procedures.

Conclusions: Compared with conventional EMR, this new method may have significant benefits, particularly regarding one-piece resection of lesions between 11 and 20 mm in size, and may also have a lower recurrence rate.

References

  • 1 Tada M, Shimada M, Murakami F, et al. Development of the strip-off biopsy (in Japanese with English abstract).  Gastroenterol Endosc. 1984;  26 833-839
  • 2 Matsushita M, Hajiro K, Okazaki K, et al. Endoscopic mucosal resection of gastric tumors located in the lesser curvature of the upper third of the stomach.  Gastrointest Endosc. 1997;  45 512-515
  • 3 Hirao M, Masuda K, Asanuma T, et al. Endoscopic resection of early gastric cancer and other tumors with local injection of hypertonic saline-epinephrine.  Gastrointest Endosc. 1998;  3 264-269
  • 4 Japanese Research Society for Gastric Cancer. Japanese Classification of Gastric Cancer.  Tokyo; Kanehara, 1995
  • 5 Yamao T, Shirao K, Ono H, et al. Risk factors for lymph node metastasis from intramucosal gastric carcinoma.  Cancer. 1996;  77 602-606
  • 6 Hosokawa K, Shirao K, Saito D, et al. Indication of endoscopic mucosal resection for early gastric cancer (in Japanese with English abstract).  Progr Dig Endosc. 1993;  42 11-15
  • 7 Muto M, Saito Y, Koike T, et al. Complication of endoscopic polypectomy and endoscopic mucosal resection in the stomach (in Japanese with English abstract).  Gastroenterol Endosc. 1996;  38 858-865
  • 8 Hirao M, Asanuma T, Masuda K, et al. Endoscopic resection of early gastric cancer following locally injection of hypertonic saline-epinephrine (in Japanese with English abstract).  Stomach Intest. 1988;  23 399-409

N. Boku,M.D. 

Division of Digestive Endoscopy and Gastrointestinal Oncology
National Cancer Center Hospital East

6-5-1 Kashiwanoha, Kashiwa
Chiba 277-8577
Japan


Fax: Fax:+ 81-471-346928

eMail: E-mail:nboku@east.ncc.go.jp

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