| Theme |
Forefront of endoscopic treatment in early colorectal cancer |
| Title |
Hook knife EMR method for colorectal tumors |
| Author |
Kinichi Hotta |
Department of Gastroenterology, Saku Central Hospital |
| Author |
Tsuneo Oyama |
Department of Gastroenterology, Saku Central Hospital |
| Author |
Dai Hirasawa |
Department of Gastroenterology, Saku Central Hospital |
| Author |
Akihisa Tomori |
Department of Gastroenterology, Saku Central Hospital |
| Author |
Shigeki Shimaya |
Department of Gastroenterology, Saku Central Hospital |
| Author |
Shuko Morita |
Department of Gastroenterology, Saku Central Hospital |
| Author |
Tadashi Sakurai |
Department of Gastroenterology, Saku Central Hospital |
| Author |
Yoshinori Miyata |
Department of Gastroenterology, Saku Central Hospital |
| [ Summary ] |
We have developed a new EMR method, the 'Hook knife' method, for en-bloc resection of large upper GI lesions. Recently, we applied this method to treatment of large colorectal lesions. First, we placed marks around the lesion with a Hook knife. Next, sodium hyaluronate solution was injected into the submucosal layer to separate the mucosa from the proper muscular layer. Then, we cut the mucosa around the lesion with a needle knife. Finally, we cut the submucosal fibers and vessels using a Hook knife and resected the lesion in a single piece. We have treated 10 colorectal tumors using this method. The rate of en-bloc resection was 70%, and no perforations or late bleeding occurred. In this method, we can make accurate histopathologic assessments of the retrieved specimen and expect complete resection without local recurrence. |