1. A New Technique for Endoscopic Submucosal Dissection for Early Gastric Cancer using an External Grasping Forceps
- Author
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Toshifumi Hibi, Haruhiko Ogata, Hitoshi Ichikawa, Kouichi Aiura, Hiroshi Nagata, K. Kumai, Manabu Nakashita, Hiroyuki Imaeda, Hidekazu Suzuki, Yasushi Iwao, Tatsuhiro Masaoka, Naoki Hosoe, Masaki Mori, and Nagamu Inoue
- Subjects
Male ,medicine.medical_specialty ,Forceps ,Adenocarcinoma ,Endoscopy, Gastrointestinal ,Lesion ,Stomach Neoplasms ,Submucosa ,medicine ,Humans ,Stomach cancer ,Aged ,Neoplasm Staging ,Aged, 80 and over ,Grasping forceps ,medicine.diagnostic_test ,business.industry ,Gastroenterology ,Equipment Design ,Endoscopic submucosal dissection ,Middle Aged ,medicine.disease ,Surgery ,Endoscopy ,Early Gastric Cancer ,Endoscopes, Gastrointestinal ,medicine.anatomical_structure ,Gastric Mucosa ,Female ,medicine.symptom ,business - Abstract
Background and study aims Endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) has improved the success rate of en-bloc resection. We report here on a new technique using an external grasping forceps. Patients and methods A total of 25 patients with suitable EGCs over 10 mm in diameter located in the gastric body were enrolled. After submucosal injection followed by circumcision of the lesion with a needle-knife, an external grasping forceps was introduced with the help of a second grasping forceps and anchored at the distal margin of the lesion. With gentle oral traction applied with this forceps, the lesion was dissected endoscopically in retroversion from the aboral side. Results The mean lesion size was 15.0 mm (range 10 - 25 mm). Using the technique described, all lesions could be resected en bloc with free margins. The mean procedure time was 45 min (range 30 - 80 minutes). No significant bleeding requiring blood transfusion or perforation occurred. Conclusions This technical modification may simplify and shorten the gastric ESD procedure, except for lesions in distal locations, without compromising the efficacy.
- Published
- 2006
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