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Study on endoscopic esophageal mucosal resection with ligating device. II--Experimental study
Y Naritaka1, K Ogawa, T Shimakawa
1Department of Surgery, Tokyo Women's Medical University, Daini Hospital, 2-1-10 Nishiogu Arakawa-ku, Tokyo 116-8567, Japan. nari4121@ca.mbn.or.jp
Background/Aims:
This study reports on animal experiments regarding the safety of endoscopic esophageal mucosal resection with a ligating device (EEMRL), as well as the amount of mucosa which can be removed by this technique, the depth of resection and the feasibility of piecemeal resection.
Methodology:
Three experiments were performed in six mongrel dogs under general anesthesia.
Results:
When EEMRL was done without submucosal injection of saline, resection reached the muscular layer and caused esophageal perforation. The average dimensions of the mucosal pieces resected using 8-, 10-, and 12-mm devices was 13 x 10 mm, 18 x 15 mm, and 22 x 18 mm, respectively. Resection reached the mid-plane of the submucosa and the depth was almost uniform. After piecemeal resection, there was no macroscopically visible mucosa at the resection site and each mucosal piece was resected along the mid-plane of the submucosa.
Conclusions:
The experimental study indicated that submucosal injection of saline is essential to prevent esophageal perforation. It also showed that EEMRL allows resection up to the mid-plane of the submucosa, that the 12-mm device allows en bloc resection of lesions < or = 15 mm in diameter and that EEMRL is suitable for piecemeal resection.