Elsevier

Gastrointestinal Endoscopy

Volume 42, Issue 5, November 1995, Pages 475-479
Gastrointestinal Endoscopy

Endoscopic aspiration mucosectomy as curative endoscopic surgery: Analysis of 24 cases of early gastric cancer,☆☆,

https://doi.org/10.1016/S0016-5107(95)70053-6Get rights and content

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PATIENTS AND METHODS

From August 1992 through October 1993, we used EAM in 24 patients with early gastric cancer or adenoma, including 11 early gastric cancers and 15 adenomas. Five lesions were located in the upper third of the stomach, 9 in the middle third, and 12 in the lower third. Twelve patients were men and 12 were women. The mean age was 68 ± 9 years. We explained the method, its effectiveness, and the possibility of complications to the patients, and obtained their consent.

Lymph node metastasis from very

RESULTS

Scanning images of tumors and submucosal separation are presented in Fig. 3.

. Scanning by UP before and after separation of the submucosal layer. A, UP scanning before separation shows a hypoechoic tumor in the first and second layer of the stomach (arrow). The third layer appears to be preserved. B, UP scanning after separation shows sufficient Glyceol (thin arrow) between the tumor (bold arrow) and the muscularis propria.

Endosonographic scanning before separation of the submucosal layer of

DISCUSSION

Today there are various kinds of EMR available in Japan.1, 2, 3, 4, 5, 6, 12, 13, 14, 15, 16, 17 Strip biopsy is by far the most popular

. A, Endoscopic appearance of flat protruding gastric cancer. A round piece of rubber near the tumor indicates that the diameter of the tumor is about 1 cm. B, Round specimen stretched after resection. The mucosal surface is congested but not injured. C, Histologic section of specimen seen through a dissecting microscope. A well-differentiated adenocarcinoma

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    After the lesion looks similar to a snared polypoid lesion, blend electrosurgical current is typically used to resect the lesion. The EAM hood uses a conventional hood (Create Medic; Yokohama, Japan) and this method is similar to EMRC.3,4 The endoscopist inserts the crescent-shaped snare through the accessory channel tube of the EAM hood and opens this snare around the lesion.

  • Comparison of EMR and endoscopic submucosal dissection for en bloc resection of early esophageal cancers in Japan

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    May et al17 compared EMRC and EMR with ligation18 and found similar results for the maximum size and calculated area of the resected specimens in a randomized study. Tanabe et al16 compared a 2-channel EMR with a modified EMRC method (endoscopic aspiration mucosectomy method19) in esophageal squamous-cell carcinomas of various sizes and found no significant difference in the en bloc resection rates. However, the resected specimen size was larger in the modified EMRC method.

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From the First Department of Internal Medicine, Department of Gastroenterological Endoscopy, and the First Department of Surgery, Faculty of Medicine, Kyoto University, Kyoto, Japan.

☆☆

Reprint requests: Ayao Torii, MD, Internal Medicine, Kyoto University, Sakyo-ku, Kyoto, 606-01, Japan.

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