Related Experiment Videos
Endoscopic submucosal dissection with internal traction for early gastric cancer (with video)
Peng-Jen Chen1, Heng-Cheng Chu, Wei-Kuo Chang
1Taipei, Taiwan.
Background:
EMR techniques have high success rates for treating small lesions of the upper-GI tract; however, tumors larger than 15 mm are frequently removed by piecemeal resection, which is associated with an increased rate of disease recurrence and difficulty in histologically evaluating the specimen.
Objective:
To describe a simple technique of using internal traction to facilitate endoscopic submucosal dissection (ESD) procedures in the excision of large, early gastric cancers.
Design:
Case series.
Setting:
A tertiary medical center in Taiwan.
Patients And Methods:
Eight patients with early gastric cancers larger than 20 mm underwent ESD.
Interventions:
A standard hemoclip modified with surgical suture was used to provide traction to improve visualization of the dissection plane during ESD.
Main Outcome Measurements:
Proportion with complete en bloc resection.
Results:
En bloc resection of the lesion was achieved in 8 patients. One patient underwent additional surgery because an adequate safe margin was not obtained by ESD.
Limitations:
One endoscopist performed all procedures, and only 8 patients were studied in an uncontrolled manner.
Conclusions:
The internal traction method appears to facilitate en bloc ESD of early gastric cancers larger than 20 mm.
