Large early gastric cancers treated by endoscopic submucosal dissection with an insulation-tipped diathermic knife

Chun Chao Chang, Cheng Tiong, Chia Lang Fang, Shiann Pan, Jean-Dean Liu, Horng Yuan Lou, Ching Ruey Hsieh, Sheng-Hsuan Chen

Research output: Contribution to journalArticle

3 Citations (Scopus)


It is difficult to remove a large early gastric cancer (≥ 3 cm) in one-piece resection using conventional endoscopic mucosal resection. We tried to use an insulation-tipped (IT) diathermic knife to dissect these lesions. IT-endoscopic submucosal dissection (ESD) was performed in four aging patients with gastric malignancy. All lesions could be removed in one-piece resection by IT-ESD, although three of them exhibited remarkable fibrosis and ulceration. Three cases experienced curative treatment with IT-ESD after the pathologic evaluation, but it was not curative in one case because the pathology showed angiolymphatic invasion. This patient refused additional surgery in consideration of existing major systemic diseases. At 3 months to 1 year of follow-up, endoscopy showed no evidence of residual cancer. IT-ESD is effective in the treatment of large early gastric cancer and is an alternative treatment for early gastric cancer patients who are at risk for major operation.

Original languageEnglish
Pages (from-to)260-264
Number of pages5
JournalJournal of the Formosan Medical Association = Taiwan yi zhi
Issue number3
Publication statusPublished - Mar 2007



  • Endoscopic mucosal resection
  • Endoscopic submucosal dissection
  • Gastric cancer

ASJC Scopus subject areas

  • Medicine(all)

Cite this