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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
Hepato-Gastroenterology
|August 9, 2001
Summary
Submucosal saline injection is crucial for safe endoscopic esophageal mucosal resection (EEMRL) using a ligating device, preventing perforation. This technique allows precise resection up to the submucosa, suitable for piecemeal removal of lesions.
Area of Science:
- Gastroenterology
- Endoscopic Surgery
- Animal Research
Background:
- Endoscopic esophageal mucosal resection (EEMRL) is a developing technique.
- Assessing the safety and efficacy of EEMRL is important for clinical application.
Purpose of the Study:
- To evaluate the safety of EEMRL in animal models.
- To determine the resection capacity and depth of EEMRL.
- To assess the feasibility of piecemeal resection using EEMRL.
Main Methods:
- Animal experiments were conducted on six mongrel dogs under general anesthesia.
- EEMRL was performed with and without submucosal saline injection.
- Resection dimensions and depth were analyzed for different device sizes (8, 10, 12 mm).
Main Results:
- Resection without submucosal saline injection led to esophageal perforation.
- The 8, 10, and 12-mm devices resected mucosal pieces with average dimensions of 13x10 mm, 18x15 mm, and 22x18 mm, respectively.
- Resection consistently reached the mid-plane of the submucosa, with no visible mucosa remaining after piecemeal resection.
Conclusions:
- Submucosal saline injection is essential to prevent esophageal perforation during EEMRL.
- EEMRL enables resection up to the submucosal mid-plane.
- The 12-mm device is effective for en bloc resection of lesions up to 15 mm, and EEMRL is suitable for piecemeal resection.