| Theme | Expansion of Indications for Endoscopic Mucosal Resection of Early Gastrointinal Cancer | |
|---|---|---|
| Title | Endoscopic Mucosal Resection using Hooking knife (hooking EMR) for Esophageal Early Cancer | |
| Publish Date | 2001/11 | |
| Author | Tsuneo Oyama | Department of Gastroenterology, Saku Central Hospital |
| Author | Yuichi Kikuchi | Department of Endoscopy, Saku Central Hospital |
| Author | Akihisa Tomori | Department of Gastroenterology, Saku Central Hospital |
| Author | Kin-ichi Hotta | Department of Gastroenterology, Saku Central Hospital |
| Author | Shigeki Shimaya | Department of Gastroenterology, Saku Central Hospital |
| Author | Yoshinori Miyata | Department of Gastroenterology, Saku Central Hospital |
| [ Summary ] | The lymphnodal metastasis of esophageal mucosal squamous cell carcinoma is very rare. Therefor, endoscopic mucosal resection (EMR) was selected for the treatment of those diseases, instead of esophagectomy. However, the size of endoscopic resected specimens was 10-20mm, so piecemeal resection was performed on large lesions. The histological examination of piecemeal resected specimens was difficult, compared with en-bloc resected specimens. We developed a new EMR method called "Hooking EMR" to resect larger enbloc specimens. At first, we placed marks around the lesion using a coagulation needle. Then, a saline diluted epinephrine solution was injected into the submucosal layer, to separate the mucosal lesion from the muscular layer proper. Then, we cut the mucosa, using a needle knife. Next, we cut the submucosal fibers, using a hooking knife, and resected the lesion without using a snare. A large en-bloc resection, 70mm or more over in size, was possible with this new method. Therefor, the histological examination of both the range of lateral spread and depth of invasion can be more precisely performed. The hooking EMR method is a new, useful EMR method for the wider precise use of EMR. |
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