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image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Gastrointestinal End...arrow_drop_down
image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao
Gastrointestinal Endoscopy
Article . 2009 . Peer-reviewed
License: Elsevier TDM
Data sources: Crossref
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A new technique for gastric endoscopic submucosal dissection: peroral traction-assisted endoscopic submucosal dissection

Authors: Won Joong, Jeon; Il Young, You; Hee Bok, Chae; Seon Mee, Park; Sei Jin, Youn;

A new technique for gastric endoscopic submucosal dissection: peroral traction-assisted endoscopic submucosal dissection

Abstract

Compared with conventional EMR, endoscopic submucosal dissection (ESD) has a higher en bloc resection rate and complete resection rate, regardless of tumor size, in treating gastric neoplasms. However, ESD leads to more complications, such as bleeding or perforation, and, in particular, needs more procedure time than a conventional EMR.To report a new technique for ESD, peroral traction-assisted ESD with suture material, to perform easier and more rapid procedures in treating gastric neoplasms and to report the technique's early results.A case series.A tertiary medical center.A total of 15 patients with gastric adenomas or early gastric cancers larger than 10 mm in diameter were consecutively enrolled. After marking around the periphery of the lesion, submucosal injection, followed by circumferential mucosal incision with a Flex-knife and an insulation-tipped knife, was conducted. After that, one hemostatic clip, tied by using a white silk suture, was applied at a site of the lesion suitable for oral traction. During submucosal dissection, the applied suture material was pulled to the oral side. Additional tractions were applied as needed.En bloc resection rate, procedure time, complications.All lesions were resected en bloc with free lateral and vertical margins by using this technique. The mean longest lesion size and specimen size were 18.1 mm (range 11-28 mm) and 43.7 mm in diameter (range 25-64 mm), respectively. The mean procedure time was 49.6 minutes (range 28-90 minutes). There was no significant bleeding that required blood transfusion or perforation related to the procedures.Single endoscopist, small patient number.Peroral traction-assisted ESD with suture material is useful in treating gastric neoplasms located in various regions of the stomach. It may make ESD procedures easier, faster, and safer under better direct vision of the submucosal layer.

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Keywords

Adenoma, Male, Mouth, Dissection, Biopsy, Needle, Adenocarcinoma, Middle Aged, Prognosis, Immunohistochemistry, Risk Assessment, Sensitivity and Specificity, Sampling Studies, Gastric Mucosa, Gastroscopy, Humans, Minimally Invasive Surgical Procedures, Female, Gastroscopes, Aged, Neoplasm Staging

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
91
Top 10%
Top 1%
Top 10%
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