Abstract
Many endoscopic mucosal resection (EMR) techniques have been developed in Japan for the treatment of gastric mucosal lesions. They have become a popular practice not only in Japan but also in many Western countries. However, conventional EMR techniques have limitations in size and location. Piecemeal resection often becomes necessary in the case of large and difficult lesions. En bloc resection is desirable, because histological evaluations are essential to estimate the risk for lymph node metastasis, and prevention of local recurrence is also very important. To conduct reliable en bloc resection, endoscopic submucosal dissection (ESD) was developed using new electrosurgical knives specially designed for the ESD technique. The way of conducting an actual ESD procedure differs depending on the features of each knife. Operators should fully understand the features of these knives and select the appropriate one according to the situation and their skills. ESD is a wonderful technique that realizes en bloc resection of relatively large and difficult lesions that are impossible to treat by the conventional EMR technique.
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References
Tada M, Shimada M, Murakami F, et al (1984) Development of the strip-off biopsy (in Japanese with English abstract). Gastroenterol Endosc 26:833–839
Inoue H, Takeshita K, Hori H, et al (1993) Endoscopic mucosal resection with a capfitted panendoscope for esophagus, stomach, and colon mucosal lesions. Gastrointest Endosc 39:58–62
Torii A, Sakai M, Kajiyama T, et al (1995) Endoscopic aspiration mucosectomy as curative endoscopic surgery; analysis of 24 cases of early gastric cancer. Gastrointest Endosc 42:475–479
Hamada T, Kondo K, Itagaki Y, et al (1998) Possibility of complete resection by endoscopic mucosal resection using the piecemeal method (in Japanese with English abstract). Stomach Intest (Tokyo) 33:1609–1617
Hirao M, Masuda K, Asanuma T, et al (1988) Endoscopic resection of early gastric cancer and other tumors with local injection of hypertonic saline-epinephrine. Gastrointest Endosc 34:264–269
Yamamoto H, Koiwai H, Yube T, et al (1999) A successful single-step endoscopic resection of a 40 millimeter flat-elevated tumor in the rectum: endoscopic mucosal resection using sodium hyaluronate. Gastrointest Endosc 50:701–704
Ono H (2005) Endoscopic submucosal dissection for early gastric cancer. Chin J Dig Dis 6:119–121
Yahagi N, Fujishiro M, Kakushima N, et al (2004) Endoscopic submucosal dissection for early gastric cancer using the tip of an electrosurgical snare (thin type). Dig Endosc 16:34–38
Ookuwa M, Hosokawa K, Boku N, et al (2001) New endoscopic treatment for intramucosal tumors using an insulated-tip diathermic knife. Endoscopy 33:221–226
Yahagi N, Fujishiro M, Kakushima N, et al (2005) Clinical evaluation of the multibending scope in various endoscopic procedures of the upper GI tract. Dig Endosc 17:S94–S96
Yamamoto H, Yube T, Isoda N, et al (1999) A novel method of endoscopic mucosal resection using sodium hyaluronate. Gastrointest Endosc 50:251–256
Fujishiro M, Yahagi N, Kashimura K, et al (2004) Comparison of various submucosal injection solutions for maintaining mucosal elevation during endoscopic mucosal resection. Endoscopy 36:579–583
Yamamoto H, Yahagi N, Oyama T, et al (2008) Usefulness and safety of 0.4% sodium hyaluronate solution as a submucosal fluid “cushion” in endoscopic resection for gastric neoplasms: a prospective multicenter trial. Gastrointest Endosc 6:830–838
Oyama T, Kikuchi Y (2002) Aggressive endoscopic mucosal resection in the upper GI tract: hook knife method. Minim Invasive Ther Allied Technol 11:291–295
Yahagi N, Fujishiro M, Imagawa A, et al (2004) Endoscopic submucosal dissection for the reliable en bloc resection of colorectal mucosal tumors. Dig Endosc 16:S89–S92
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Yahagi, N. (2008). Features of Therapeutic Devices for Gastric Endoscopic Submucosal Dissection and Basic Techniques. In: Niwa, H., Tajiri, H., Nakajima, M., Yasuda, K. (eds) New Challenges in Gastrointestinal Endoscopy. Springer, Tokyo. https://doi.org/10.1007/978-4-431-78889-8_22
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DOI: https://doi.org/10.1007/978-4-431-78889-8_22
Publisher Name: Springer, Tokyo
Print ISBN: 978-4-431-78888-1
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