Successful en bloc resection of a large superficial gastric cancer by using sodium hyaluronate and electrocautery incision forceps

Background: The advisability of endoscopic mucosal resection (EMR) for treatment of large superficial gastric cancers has been challenged. For more reliable en bloc resection, a new method of EMR was developed that uses a viscous substance, sodium hyaluronate, and two newly designed devices. Methods...

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Bibliographic Details
Published in:Gastrointestinal endoscopy 2001-11, Vol.54 (5), p.629-632
Main Authors: Yamamoto, Hironori, Sekine, Yutaka, Higashizawa, Toshihiko, Kihira, Ken, Kaneko, Yoshinari, Hosoya, Yoshinori, Ido, Kenichi, Saito, Ken, Sugano, Kentaro
Format: Article
Language:English
Subjects:
Aged
Biological and medical sciences
Diseases of the digestive system
Electrocoagulation - instrumentation
Endoscopy, Gastrointestinal
Humans
Hyaluronic Acid - administration & dosage
Male
Medical sciences
Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
Stomach Neoplasms - pathology
Stomach Neoplasms - surgery
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Summary:Background: The advisability of endoscopic mucosal resection (EMR) for treatment of large superficial gastric cancers has been challenged. For more reliable en bloc resection, a new method of EMR was developed that uses a viscous substance, sodium hyaluronate, and two newly designed devices. Methods: A large superficial gastric cancer was treated with this new EMR technique. Sodium hyaluronate was injected into the submucosa and mucosal incisions were made with a needle-knife. The newly developed incision forceps and flat-ended transparent hood were used for submucosal incisions. Results: The large cancer was successfully resected endoscopically as a single piece of mucosa 6 cm in diameter without complication. Histopathologic evaluation of the specimen confirmed that the resection was curative. Conclusions: EMR with sodium hyaluronate along with two new devices may be a reliable method for en bloc resection of large superficial gastric lesions.
ISSN:0016-5107
1097-6779
DOI:10.1067/mge.2001.118643