Endoscopic submucosal dissection with internal traction for early gastric cancer (with video)

Peng-Jen Chen, Heng-Cheng Chu, Wei-Kuo Chang, Tsai-Yuan Hsieh, You-Chen Chao

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

Background: EMR techniques have high success rates for treating small lesions of the upper-GI tract; however, tumors larger than 15 mm are frequently removed by piecemeal resection, which is associated with an increased rate of disease recurrence and difficulty in histologically evaluating the specimen. Objective: To describe a simple technique of using internal traction to facilitate endoscopic submucosal dissection (ESD) procedures in the excision of large, early gastric cancers. Design: Case series. Setting: A tertiary medical center in Taiwan. Patients and Methods: Eight patients with early gastric cancers larger than 20 mm underwent ESD. Interventions: A standard hemoclip modified with surgical suture was used to provide traction to improve visualization of the dissection plane during ESD. Main Outcome Measurements: Proportion with complete en bloc resection. Results: En bloc resection of the lesion was achieved in 8 patients. One patient underwent additional surgery because an adequate safe margin was not obtained by ESD. Limitations: One endoscopist performed all procedures, and only 8 patients were studied in an uncontrolled manner. Conclusions: The internal traction method appears to facilitate en bloc ESD of early gastric cancers larger than 20 mm. © 2008 American Society for Gastrointestinal Endoscopy.
Original languageEnglish
Pages (from-to)128-132
Number of pages5
JournalGastrointestinal Endoscopy
Volume67
Issue number1
DOIs
Publication statusPublished - 2008
Externally publishedYes

Fingerprint

Traction
Stomach Neoplasms
Upper Gastrointestinal Tract
Gastrointestinal Endoscopy
Taiwan
Sutures
Dissection
Endoscopic Mucosal Resection
Recurrence
Neoplasms

Keywords

  • adult
  • aged
  • article
  • cancer patient
  • cancer surgery
  • clinical article
  • clip
  • controlled study
  • endoscopic surgery
  • female
  • gastrointestinal endoscopy
  • histopathology
  • human
  • male
  • priority journal
  • stomach cancer
  • suture
  • Taiwan
  • tertiary health care
  • tumor biopsy
  • Aged
  • Aged, 80 and over
  • Endoscopy, Gastrointestinal
  • Female
  • Humans
  • Male
  • Middle Aged
  • Stomach Neoplasms

Cite this

Endoscopic submucosal dissection with internal traction for early gastric cancer (with video). / Chen, Peng-Jen; Chu, Heng-Cheng; Chang, Wei-Kuo; Hsieh, Tsai-Yuan; Chao, You-Chen.

In: Gastrointestinal Endoscopy, Vol. 67, No. 1, 2008, p. 128-132.

Research output: Contribution to journalArticle

Chen, Peng-Jen ; Chu, Heng-Cheng ; Chang, Wei-Kuo ; Hsieh, Tsai-Yuan ; Chao, You-Chen. / Endoscopic submucosal dissection with internal traction for early gastric cancer (with video). In: Gastrointestinal Endoscopy. 2008 ; Vol. 67, No. 1. pp. 128-132.
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abstract = "Background: EMR techniques have high success rates for treating small lesions of the upper-GI tract; however, tumors larger than 15 mm are frequently removed by piecemeal resection, which is associated with an increased rate of disease recurrence and difficulty in histologically evaluating the specimen. Objective: To describe a simple technique of using internal traction to facilitate endoscopic submucosal dissection (ESD) procedures in the excision of large, early gastric cancers. Design: Case series. Setting: A tertiary medical center in Taiwan. Patients and Methods: Eight patients with early gastric cancers larger than 20 mm underwent ESD. Interventions: A standard hemoclip modified with surgical suture was used to provide traction to improve visualization of the dissection plane during ESD. Main Outcome Measurements: Proportion with complete en bloc resection. Results: En bloc resection of the lesion was achieved in 8 patients. One patient underwent additional surgery because an adequate safe margin was not obtained by ESD. Limitations: One endoscopist performed all procedures, and only 8 patients were studied in an uncontrolled manner. Conclusions: The internal traction method appears to facilitate en bloc ESD of early gastric cancers larger than 20 mm. {\circledC} 2008 American Society for Gastrointestinal Endoscopy.",
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author = "Peng-Jen Chen and Heng-Cheng Chu and Wei-Kuo Chang and Tsai-Yuan Hsieh and You-Chen Chao",
note = "被引用次數:23 Export Date: 22 March 2016 CODEN: GAENB 通訊地址: Chao, Y.-C.; Current affiliations: Division of Gastroenterology, Tri-Service General Hospital, Taipei, Taiwan 參考文獻: Soetikno, R., Gotoda, T., Nakanishi, Y., Endoscopic mucosal resection (2003) Gastrointest Endosc, 57, pp. 567-579; Tanabe, S., Koizumi, W., Mitomi, H., Clinical outcome of endoscopic aspiration mucosectomy for early stage gastric cancer (2002) Gastrointest Endosc, 56, pp. 708-713; Gotoda, T., Endoscopic diagnosis and treatment for early gastric cancer (2004) Cancer Reviews: Asia-Pacific, 2, pp. 17-37; Kondo, H., Gotoda, T., Ono, H., Percutaneous traction-assisted EMR by using an insulation-tipped electrosurgical knife for early stage gastric cancer (2004) Gastrointest Endosc, 59, pp. 284-288; Kobayashi, T., Gotohda, T., Tamakawa, K., Magnetic anchor for more effective endoscopic mucosal resection (2004) Jpn J Clin Oncol, 34, pp. 118-123; Imaeda, H., Iwao, Y., Ogata, H., A new technique for endoscopic submucosal dissection for early gastric cancer using an external grasping forceps (2006) Endoscopy, 38, pp. 1007-1010; Onozato, Y., Ishihara, H., Iizuka, H., Endoscopic submucosal dissection for early gastric cancers and large flat adenomas (2006) Endoscopy, 38, pp. 980-986; Lee, I.L., Lin, P.Y., Tung, S.Y., Endoscopic submucosal dissection for the treatment of intraluminal gastric subepithelial tumors originating from the muscularis propria layer (2006) Endoscopy, 38, pp. 1024-1028; Chen, P.J., Hsieh, T.Y., Chao, Y.C., Clinical challenges and images in GI (2007) Gastroenterology, 132, p. 853. , 1209; Saito, Y., Emura, F., Matsuda, T., A new sinker-assisted endoscopic submucosal dissection for colorectal cancer (2005) Gastrointest Endosc, 62, pp. 297-301; Yamamoto, H., Kawata, H., Sunada, K., Successful en-bloc resection of large superficial tumors in the stomach and colon using sodium hyaluronate and small-caliber-tip transparent hood (2003) Endoscopy, 35, pp. 690-694; Yonezawa, J., Kaise, M., Sumiyama, K., A novel double-channel therapeutic endoscope ({"}R-scope{"}) facilitates endoscopic submucosal dissection of superficial gastric neoplasms (2006) Endoscopy, 38, pp. 1011-1015; Neuhaus, H., Costamagna, G., Devi{\`e}re, J., Endoscopic submucosal dissection (ESD) of early neoplastic gastric lesions using a new double-channel endoscope (the {"}R-scope{"}) (2006) Endoscopy, 38, pp. 1016-1023",
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TY - JOUR

T1 - Endoscopic submucosal dissection with internal traction for early gastric cancer (with video)

AU - Chen, Peng-Jen

AU - Chu, Heng-Cheng

AU - Chang, Wei-Kuo

AU - Hsieh, Tsai-Yuan

AU - Chao, You-Chen

N1 - 被引用次數:23 Export Date: 22 March 2016 CODEN: GAENB 通訊地址: Chao, Y.-C.; Current affiliations: Division of Gastroenterology, Tri-Service General Hospital, Taipei, Taiwan 參考文獻: Soetikno, R., Gotoda, T., Nakanishi, Y., Endoscopic mucosal resection (2003) Gastrointest Endosc, 57, pp. 567-579; Tanabe, S., Koizumi, W., Mitomi, H., Clinical outcome of endoscopic aspiration mucosectomy for early stage gastric cancer (2002) Gastrointest Endosc, 56, pp. 708-713; Gotoda, T., Endoscopic diagnosis and treatment for early gastric cancer (2004) Cancer Reviews: Asia-Pacific, 2, pp. 17-37; Kondo, H., Gotoda, T., Ono, H., Percutaneous traction-assisted EMR by using an insulation-tipped electrosurgical knife for early stage gastric cancer (2004) Gastrointest Endosc, 59, pp. 284-288; Kobayashi, T., Gotohda, T., Tamakawa, K., Magnetic anchor for more effective endoscopic mucosal resection (2004) Jpn J Clin Oncol, 34, pp. 118-123; Imaeda, H., Iwao, Y., Ogata, H., A new technique for endoscopic submucosal dissection for early gastric cancer using an external grasping forceps (2006) Endoscopy, 38, pp. 1007-1010; Onozato, Y., Ishihara, H., Iizuka, H., Endoscopic submucosal dissection for early gastric cancers and large flat adenomas (2006) Endoscopy, 38, pp. 980-986; Lee, I.L., Lin, P.Y., Tung, S.Y., Endoscopic submucosal dissection for the treatment of intraluminal gastric subepithelial tumors originating from the muscularis propria layer (2006) Endoscopy, 38, pp. 1024-1028; Chen, P.J., Hsieh, T.Y., Chao, Y.C., Clinical challenges and images in GI (2007) Gastroenterology, 132, p. 853. , 1209; Saito, Y., Emura, F., Matsuda, T., A new sinker-assisted endoscopic submucosal dissection for colorectal cancer (2005) Gastrointest Endosc, 62, pp. 297-301; Yamamoto, H., Kawata, H., Sunada, K., Successful en-bloc resection of large superficial tumors in the stomach and colon using sodium hyaluronate and small-caliber-tip transparent hood (2003) Endoscopy, 35, pp. 690-694; Yonezawa, J., Kaise, M., Sumiyama, K., A novel double-channel therapeutic endoscope ("R-scope") facilitates endoscopic submucosal dissection of superficial gastric neoplasms (2006) Endoscopy, 38, pp. 1011-1015; Neuhaus, H., Costamagna, G., Devière, J., Endoscopic submucosal dissection (ESD) of early neoplastic gastric lesions using a new double-channel endoscope (the "R-scope") (2006) Endoscopy, 38, pp. 1016-1023

PY - 2008

Y1 - 2008

N2 - Background: EMR techniques have high success rates for treating small lesions of the upper-GI tract; however, tumors larger than 15 mm are frequently removed by piecemeal resection, which is associated with an increased rate of disease recurrence and difficulty in histologically evaluating the specimen. Objective: To describe a simple technique of using internal traction to facilitate endoscopic submucosal dissection (ESD) procedures in the excision of large, early gastric cancers. Design: Case series. Setting: A tertiary medical center in Taiwan. Patients and Methods: Eight patients with early gastric cancers larger than 20 mm underwent ESD. Interventions: A standard hemoclip modified with surgical suture was used to provide traction to improve visualization of the dissection plane during ESD. Main Outcome Measurements: Proportion with complete en bloc resection. Results: En bloc resection of the lesion was achieved in 8 patients. One patient underwent additional surgery because an adequate safe margin was not obtained by ESD. Limitations: One endoscopist performed all procedures, and only 8 patients were studied in an uncontrolled manner. Conclusions: The internal traction method appears to facilitate en bloc ESD of early gastric cancers larger than 20 mm. © 2008 American Society for Gastrointestinal Endoscopy.

AB - Background: EMR techniques have high success rates for treating small lesions of the upper-GI tract; however, tumors larger than 15 mm are frequently removed by piecemeal resection, which is associated with an increased rate of disease recurrence and difficulty in histologically evaluating the specimen. Objective: To describe a simple technique of using internal traction to facilitate endoscopic submucosal dissection (ESD) procedures in the excision of large, early gastric cancers. Design: Case series. Setting: A tertiary medical center in Taiwan. Patients and Methods: Eight patients with early gastric cancers larger than 20 mm underwent ESD. Interventions: A standard hemoclip modified with surgical suture was used to provide traction to improve visualization of the dissection plane during ESD. Main Outcome Measurements: Proportion with complete en bloc resection. Results: En bloc resection of the lesion was achieved in 8 patients. One patient underwent additional surgery because an adequate safe margin was not obtained by ESD. Limitations: One endoscopist performed all procedures, and only 8 patients were studied in an uncontrolled manner. Conclusions: The internal traction method appears to facilitate en bloc ESD of early gastric cancers larger than 20 mm. © 2008 American Society for Gastrointestinal Endoscopy.

KW - adult

KW - aged

KW - article

KW - cancer patient

KW - cancer surgery

KW - clinical article

KW - clip

KW - controlled study

KW - endoscopic surgery

KW - female

KW - gastrointestinal endoscopy

KW - histopathology

KW - human

KW - male

KW - priority journal

KW - stomach cancer

KW - suture

KW - Taiwan

KW - tertiary health care

KW - tumor biopsy

KW - Aged

KW - Aged, 80 and over

KW - Endoscopy, Gastrointestinal

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Stomach Neoplasms

U2 - 10.1016/j.gie.2007.07.021

DO - 10.1016/j.gie.2007.07.021

M3 - Article

VL - 67

SP - 128

EP - 132

JO - Gastrointestinal Endoscopy

JF - Gastrointestinal Endoscopy

SN - 0016-5107

IS - 1

ER -