Abstract
PURPOSE: A transparent plastic cap of 17 mm in outer diameter, 15 mm in inner diameter, and 10 mm in length can be easily attached to the tip of a colonoscope. By using the cap, a better view of the lesions hiding at the opposite side of the fold can be obtained. When a flat colonic lesion is found, a submucosal injection of saline solution is performed, the target mucosa is sucked inside the cap, snared under a full endoscopic suction, and resected by an electrical current. This procedure is called endoscopic mucosal resection using transparent cap-fitted endoscope (EMRC). Feasibility of the cap-fitted colonoscope for screening colonoscopic examination and mucosal resection was evaluated. MATERIALS AND METHODS: One hundred forty patients were randomly allocated for screening with a normal colonoscope (NCF) or that with the cap-fitted colonoscope (CCF). Average time for insertion up to the cecum, patients' discomfort during insertion expressed in 4 degrees, and average number of lesions found in one patient were compared. Thirty lesions randomly allocated for mucosal resection with conventional strip biopsy or EMRC were also evaluated. RESULTS: Time consumed for insertion up to the cecum with the CCF (12.4±6.6 minutes) was the same as that with the NCF (12.3±5.2 minutes), and there was no significant difference in patients' discomfort; however, the average number of lesions found in one patient was larger when using the CCF (0.86±0.96) than when using the NCF (0.58±0.81). For mucosal resection, 40 flat or wide-based lesions including 6 mucosal carcinomas were resected with EMRC. We experienced only one pinhole perforation of the ascending colon by heat damage, which was treated successfully by surgery. There was no other major complication or recurrence. CONCLUSION: The cap-fitted endoscope was equal in maneuverability, was excellent in sensitivity in comparison with the regular colonoscope, and was thought to be feasible both in screening and mucosal resection.
Similar content being viewed by others
References
Cooper HS. Surgical pathology of endoscopically removed malignant polyps of the colon and rectum [abstract]. Lab Invest 1983;48:17.
Morson BC, Whitway JE, Jones EA, Macrae FA, Williams CB. Histopathology and prognosis of malignant colorectal polyps treated by endoscopic polypectomy. Gut 1984;25:437–44.
Stolte M, Bethke B. Colorectal mini-de novo carcinoma: a reality in Germany too. Endoscopy 1995;27:286–90.
Karita M, Tada M, Okita K, Kodama T. Endoscopic therapy for early colon cancer: the strip biopsy resection technique. Gastrointest Endosc 1991;37:128–32.
Inoue H, Endo M. Endoscopic esophageal mucosal resection using transparent tube. Surg Endosc 1990;4:198–201.
Inoue H, Takeshita K, Hori H, Muraoka Y, Yoneshima H, Endo M. Endoscopic mucosal resection with a cap-fitted panendoscope for esophagus, stomach, and colon mucosal lesions. Gastrointest Endosc 1993;39:58–62.
Tada M, Inoue H, Yabata E, Okabe S, Takeshita K, Endo M. Colonic mucosal resection with transparent cap-fitted colonoscope. Gastrointest Endosc 1996;44:63–5.
Author information
Authors and Affiliations
Additional information
Read at the meeting of The American Society of Colon and Rectal Surgeons, Seattle, Washington, June 9–14, 1996.
About this article
Cite this article
Tada, M., Inoue, H., Yabata, E. et al. Feasibility of the transparent cap-fitted colonoscope for screening and mucosal resection. Dis Colon Rectum 40, 618–621 (1997). https://doi.org/10.1007/BF02055390
Issue Date:
DOI: https://doi.org/10.1007/BF02055390