Endoscopic submucosal dissection for early gastric cancer using the tip of an electrosurgical snare (thin type)

Naohisa Yahagi, Mitsuhiro Fujishiro, Naomi Kakushima, Katsuya Kobayashi, Takuhei Hashimoto, Masashi Oka, Mikitaka Iguchi, Shotaro Enomoto, Masao Ichinose, Hirohumi Niwa, Masao Omata

Research output: Contribution to journalArticle

219 Citations (Scopus)

Abstract

Background: Although the strip biopsy method and aspiration method are popular endoscopic mucosal resection techniques for its convenience and reliability, they have limitations in resectable tumor size and location. Endoscopic submucosal dissection techniques using the diathermic needle knife or the insulated-tip diathermic knife have been introduced to overcome this disadvantage, but they have high risks for bleeding and perforation. Therefore, we have developed a new endoscopic submucosal dissection technique using the tip of an electrosurgical snare (thin type) and assessed its efficacy. Methods: Fifty-nine lesions with differentiated-type gastric cancer without ulceration were treated with our technique at the University Hospital. The tip of an electrosurgical snare (thin type) was used for mucosal incision and submucosal dissection as a flexible diathermic knife. Results: The size of tumor was 5-85 mm in diameter (mean size: 29 mm) and the location varied from cardia to antrum. Among 59 lesions, 56 lesions (56/59, 95%) were resected completely in an en-bloc fashion with much less perforation (2/59, 3.4%) and bleeding (1/59, 1.7%) regardless of their size and location. Conclusion: New endoscopic submucosal dissection technique using the tip of an electrosurgical snare (thin type) is safe and reliable. We were able to resect early gastric cancer with a much higher en-bloc resection rate and fewer complications using this technique.

Original languageEnglish
Pages (from-to)34-38
Number of pages5
JournalDigestive Endoscopy
Volume16
Issue number1
DOIs
Publication statusPublished - 2004 Jan
Externally publishedYes

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Stomach Neoplasms
Hemorrhage
Cardia
Needles
Dissection
Neoplasms
Endoscopic Mucosal Resection

Keywords

  • Electrosurgical snare (thin type)
  • En-bloc resection
  • Endoscopic mucosal resection
  • Endoscopic submucosal dissection
  • Tip of snare

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Endoscopic submucosal dissection for early gastric cancer using the tip of an electrosurgical snare (thin type). / Yahagi, Naohisa; Fujishiro, Mitsuhiro; Kakushima, Naomi; Kobayashi, Katsuya; Hashimoto, Takuhei; Oka, Masashi; Iguchi, Mikitaka; Enomoto, Shotaro; Ichinose, Masao; Niwa, Hirohumi; Omata, Masao.

In: Digestive Endoscopy, Vol. 16, No. 1, 01.2004, p. 34-38.

Research output: Contribution to journalArticle

Yahagi, N, Fujishiro, M, Kakushima, N, Kobayashi, K, Hashimoto, T, Oka, M, Iguchi, M, Enomoto, S, Ichinose, M, Niwa, H & Omata, M 2004, 'Endoscopic submucosal dissection for early gastric cancer using the tip of an electrosurgical snare (thin type)', Digestive Endoscopy, vol. 16, no. 1, pp. 34-38. https://doi.org/10.1111/j.1443-1661.2004.00313.x
Yahagi, Naohisa ; Fujishiro, Mitsuhiro ; Kakushima, Naomi ; Kobayashi, Katsuya ; Hashimoto, Takuhei ; Oka, Masashi ; Iguchi, Mikitaka ; Enomoto, Shotaro ; Ichinose, Masao ; Niwa, Hirohumi ; Omata, Masao. / Endoscopic submucosal dissection for early gastric cancer using the tip of an electrosurgical snare (thin type). In: Digestive Endoscopy. 2004 ; Vol. 16, No. 1. pp. 34-38.
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AU - Hashimoto, Takuhei

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AU - Iguchi, Mikitaka

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AB - Background: Although the strip biopsy method and aspiration method are popular endoscopic mucosal resection techniques for its convenience and reliability, they have limitations in resectable tumor size and location. Endoscopic submucosal dissection techniques using the diathermic needle knife or the insulated-tip diathermic knife have been introduced to overcome this disadvantage, but they have high risks for bleeding and perforation. Therefore, we have developed a new endoscopic submucosal dissection technique using the tip of an electrosurgical snare (thin type) and assessed its efficacy. Methods: Fifty-nine lesions with differentiated-type gastric cancer without ulceration were treated with our technique at the University Hospital. The tip of an electrosurgical snare (thin type) was used for mucosal incision and submucosal dissection as a flexible diathermic knife. Results: The size of tumor was 5-85 mm in diameter (mean size: 29 mm) and the location varied from cardia to antrum. Among 59 lesions, 56 lesions (56/59, 95%) were resected completely in an en-bloc fashion with much less perforation (2/59, 3.4%) and bleeding (1/59, 1.7%) regardless of their size and location. Conclusion: New endoscopic submucosal dissection technique using the tip of an electrosurgical snare (thin type) is safe and reliable. We were able to resect early gastric cancer with a much higher en-bloc resection rate and fewer complications using this technique.

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