| Theme |
Colorectal endoscopic submucosal dissection |
| Title |
Techniques for and challenges with endoscopic submucosal dissection methods employing Hook knife for colorectal neoplasms |
| Author |
Kinichi Hotta |
Department of Gastroenterology, Saku Central Hospital |
| Author |
Tsuneo Oyama |
Department of Gastroenterology, Saku Central Hospital |
| Author |
Yoshinori Miyata |
Department of Gastroenterology, Saku Central Hospital |
| Author |
Akihisa Tomori |
DDepartment of Gastroenterology, Saku Central Hospital |
| Author |
Akiko Takahashi |
Department of Gastroenterology, Saku Central Hospital |
| Author |
Yoko Kitamura |
Department of Gastroenterology, Saku Central Hospital |
| Author |
Tomoaki Shinohara |
Department of Gastroenterology, Saku Central Hospital |
| Author |
Shigetaka Yoshinaga |
Department of Gastroenterology, Saku Central Hospital |
| Author |
Yoko Arai |
Department of Gastroenterology, Saku Central Hospital |
| Author |
Shinichi Furutachi |
Department of Gastroenterology, Saku Central Hospital |
| Author |
Tetsuro Yamazato |
Department of Gastroenterology, Saku Central Hospital |
| [ Summary ] |
The Hook knife was developed for endoscopic submucosal dissection (ESD). It is a useful device for all ESD processes, such as marking, mucosal cutting, submucosal dissection and hemostasis. The use of ESD for colorectal neoplasms is regarded as difficult and risky because of the bent lumen and thin colorectal walls. Therefore, we have tried to develop technical colorectal ESD standardization methods. The most important technique to prevent perforation is maintaining adequate submucosal space. A sodium hyaluronate and glycerol solution is good for this purpose. The next step is using a Hook knife for submucosal dissection, because it is the safest endo-knife.
Learning curves related to our experiences with complete en bloc resection and perforation rates were analyzed. En bloc resection rates rose to 100 % in the third quarter. Perforation rates fell to 0 % after the fourth quarter. Technical standardization of ESD for colorectal neoplasm may be possible in the future. |