| Theme |
Treatment of early rectal cancer -- Local excision vs. endoscopic resection |
| Title |
Endoscopic submucosal dissection using water jet short needle knives (Flush knife) for early stage rectal neoplasia |
| Author |
Takashi Toyonaga |
Department of Gastroenterology, Kishiwada Tokushukai Hospital |
| Author |
Eisei Nishino |
Department of Pathology, Kishiwada Tokushukai Hospital |
| Author |
Tomoomi Hirooka |
Department of Gastroenterology, Kishiwada Tokushukai Hospital |
| Author |
Chie Ueda |
Department of Gastroenterology, Kishiwada Tokushukai Hospital |
| Author |
Hayato Shinjo |
Department of Gastroenterology, Kishiwada Tokushukai Hospital |
| Author |
Wataru Ono |
Department of Gastroenterology, Kishiwada Tokushukai Hospital |
| Author |
Yoshinori Iwata |
Department of Gastroenterology, Kishiwada Tokushukai Hospital |
| Author |
Takeshi Sugiyama |
Department of Gastroenterology, Kishiwada Tokushukai Hospital |
| Author |
Toshio Dozaiku |
Department of Gastroenterology, Kishiwada Tokushukai Hospital |
| [ Summary ] |
Endoscopic treatment is indicated for rectal tumors when patients are free of lymph node metastasis, specifically, for adenomas and intra-and submucosal carcinomas (well or moderately differentiated adenocarcinomas, depth of submucosal infiltration < 1000 μm, and negative for lympho-vascular invasion). In such cases, en-bloc complete resection, using endoscopic submucosal dissection (ESD) is possible without being limited by tumor size or location. With the aim of providing ESD more safely, easily and efficiently, we have developed the water jet short needle knife (FlushKnife™). This tool facilitates mucosal incision by using the tip of its sheath as a guard, enabling safer and more uniform dissection by knife manipulation. The edge of the sheath glides over the muscle layer, using the tip of the sheath as a protector. The water jetting capability of the knife contributes to improved ESD efficiency since additional local injection can be performed without tool replacement. The FlushKnife™ is particularly effective in managing tumors located in the presence of multiple blood vessels, such as lesions in the lower rectum and those extending into the anal canal. |