Korean J Gastrointest Endosc.  2003 Jun;26(6):397-404.

Endoscopic Mucosal Resection Using Insulated-tip Electrosurgical Knife

Affiliations
  • 1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. swoopark@yumc.yonsei.ac.kr
  • 2Division of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
  • 3Division of Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.

Abstract

BACKGROUND/AIMS
Endoscopic mucosal resection (EMR) has become a standard treatment for gastric mucosal neoplasm. A new EMR technique, using an insulated-tip electrosurgical knife (IT-EMR), was developed for large mucosal lesions. The aim of this study was to evaluate the efficacy and complication of IT-EMR.
METHODS
IT-EMR was performed for 28 gastric mucosal lesions in 27 patients. En bloc resection rate, complete resection rate and complications were evaluated.
RESULTS
IT-EMR was performed successfully in 27 lesions, and one lesion was failed because of the presence of a non-lifting sign. En bloc resections were achieved in 24 lesions (88.9%), and piecemeal resections in 3 lesions. Complete resections were achieved in 23 lesions (85.2%). There were 6 episodes (22%) of bleeding which were controlled completely by endoscopic treatment, and there was no perforation. Ten lesions (37%) were adenocarcinoma, 4 (14.8%) were high-grade dysplasia, and 12 (44.5%) were low-grade dysplasia.
CONCLUSION
IT-EMR for large gastric mucosal neoplasm is a useful method for wide safety margin completeness of resection by en bloc resection.

Keyword

Insulated-tip knife; Endoscopic mucosal resection
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