Endoscopy 2003; 35(4): 348-355
DOI: 10.1055/s-2003-38153
Expert Approach Section
© Georg Thieme Verlag Stuttgart · New York

Endoscopic Mucosal Resection of Superficial Cancer in the Stomach Using the Cap Technique

M.  Tani 1 , P.  Sakai 2 , H.  Kondo 3
  • 1 Department of Surgery, Esophagogastric Division, Tokyo Medical and Dental University, Tokyo, Japan
  • 2 Gastrointestinal Endoscopy Unit of São Paulo University Medical School, São Paulo, Brazil
  • 3 Center for Digestive Diseases, Tonan Hospital, Sapporo, Japan
Further Information

Publication History

Publication Date:
27 March 2003 (online)

Objectives

Clinicopathological analyses of surgically treated early gastric cancers have revealed that some of them would have been curable by endoscopic treatment. The main endoscopic treatment currently used for early gastric cancer is endoscopic mucosal resection (EMR), which allows histopathological examination of the resected specimen. It was first described by Deyhle et al. [1] in 1973 and the procedure was established by Tada et al. [2] in the 1980s under the name of strip biopsy.

Since then various techniques of EMR for early gastric cancer have been reported, including endoscopic double-snare polypectomy (EDSP) [3], endoscopic resection following local injection of hypertonic saline-epinephrine (ERHSE) solution [4], strip biopsy [5], EMR using a cap-fitted panendoscope (EMRC) [6], and EMR using an insulated-tip diathermy knife [7]. In this report, the procedure and the results of EMRC for early gastric cancer are described. We are placing the emphasis on EMRC, because it is the most popular technique and does not require complex accessories. It is technically easier and less time-consuming. All the technical terms used in this report are in accordance with the Japanese Classification of Gastric Carcinoma [8].

References

  • 1 Deyhle H, Sulser H, Säuberli H. Endoscopic snare ectomy of an early gastric cancer: a therapeutical method.  Endoscopy. 1974;  6 195-198
  • 2 Tada M, Murata M, Murakami F. et al . Development of strip biopsy (summary in English).  Gastroenterol Endosc. 1984;  26 833-839
  • 3 Takekoshi T, Takagi K, Fujii A. et al . The treatment of early gastric cancer by endoscopic double snare polypectomy (EDSP).  Gan No Rinsho [Jpn Cancer Clin]. 1986;  32 1185-1190
  • 4 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. 1988;  34 264-269
  • 5 Tada M, Murakami A, Karita M. et al . Endoscopic resection of early gastric cancer.  Endoscopy. 1993;  25 445-450
  • 6 Inoue H, Takeshita K, Hori H. et al . Endoscopic mucosal resection with cap-fitted panendoscope for esophagus, stomach, and colon mucosal lesions.  Gastrointest Endosc. 1993;  39 58-62
  • 7 Ono H, Kondo H, Gotoda T. et al . Endoscopic mucosal resection for treatment of early gastric cancer.  Gut. 2001;  48 225-229
  • 8 Japanese Gastric Cancer Association .Japanese classification of gastric carcinoma. Gastric Cancer 1998 2nd English Edition: 10-24
  • 9 Kojima T, Parra-Blanco A, Takahashi H. et al . Outcome of endoscopic mucosal resection for early gastric cancer: review of the Japanese literature.  Gastrointest Endosc. 1998;  48 550-554
  • 10 Lambert R. Endoscopic treatment of esophagogastric tumors.  Endoscopy. 1996;  28 27-37
  • 11 Lambert R. Endoscopic treatment of esophagogastric tumors.  Endoscopy. 1998;  30 80-93
  • 12 Tani M, Takeshita K, Inoue H. et al . Adequate endoscopic mucosal resection for early gastric cancer obtained from the dissecting microscopic features of the resected specimens.  Gastric Cancer. 2001;  4 122-131
  • 13 Tani M, Kawano T, Takeshita K. EMRC procedure (in Japanese). Tokyo; Sentan Iryogijutsu Kenkyusho 2002: 110-113
  • 14 Tada M. One piece resection and piecemeal resection of early gastric cancer by strip biopsy (in Japanese with English abstract). Tokyo; Igaku Shoin 1998: 68-87
  • 15 Chonan A, Mochizuki F, Ando M. et al . Endoscopic mucosal resection (EMR) of early gastric cancer - usefulness of aspiration EMR using a cap-fitted scope.  Dig Endosc. 1998;  10 31-36

M. Tani, M.D.

Department of Surgery · Esophagogastric Division · Tokyo Medical & Dental University ·

1-5-45 Yushima · Bunkyo-ku · Tokyo 113-8519 · Japan

Fax: + 81-3-3817-4126

Email: tani.srg1@tmd.ac.jp

    >