Endoscopic submucosal dissection for early gastric cancer

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Oncology

Background:

• Endoscopic mucosal resection (EMR) is a common treatment for early gastric cancer (EGC), offering better quality of life than surgery.
• The strip biopsy method for EMR can lead to local recurrences due to fragmental resection.
• Single-fragment resection is crucial for accurate histological diagnosis and patient outcomes.

Purpose of the Study:

• To introduce and evaluate a novel endoscopic submucosal dissection (ESD) technique using the insulation-tipped electrosurgical knife (IT knife).
• To assess the efficacy and safety of the IT knife-assisted ESD for EGC treatment.
• To compare the outcomes of ESD with traditional EMR methods.

Main Methods:

• Development of the insulation-tipped electrosurgical knife (IT knife) for precise submucosal cutting.
• Application of the IT knife in endoscopic submucosal dissection (ESD) for EGC.
• Resection of EGC lesions using the IT knife-assisted ESD procedure.

Main Results:

• The IT knife-assisted ESD achieved a 96% (471/488) complete one-piece tumor resection rate.
• No local recurrences were observed during the follow-up period after ESD.
• The procedure demonstrated safety and effectiveness in resecting EGC lesions.

Conclusions:

• Endoscopic submucosal dissection (ESD) using the IT knife is a highly effective method for treating early gastric cancer (EGC).
• This technique facilitates complete, single-piece resection, enhancing histological assessment and patient prognosis.
• IT knife-assisted ESD improves quality of life and reduces recurrence rates compared to traditional EMR.