Result of Submucosal Dissection EMR Using an IT Knife Hisanao Hamanaka 1 , Takuji Gotoda 1 , Chizu Yokoi 1 1Endoscopy Division, National Cancer Center Hospital Keyword: 切開・剥離EMR法 , ITナイフ , 適応拡大 , 一括切除 pp.27-34
Published Date 2004/1/25
DOI https://doi.org/10.11477/mf.1403100408
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 EMR is widely accepted as a useful treatment for early gastric cancer. The benefit of EMR can be achieved only through careful histologic examination, so an en-bloc resection is recommended. Among 1,441 lesions treated by EMR from 1987 to 2002 at the National Cancer Center Hospital, the percentage of tumors removed by en-bloc resection was 77 % and, by piecemeal resection, it was 23 %. In histologic assessment, the not-evaluable resection was only 4 % in the group of en-bloc resection compared with 30 % in the piecemeal resection group. In the last 3 years, submucosal dissection EMR using an IT knife was performed for almost all early gastric cancers in our division. 97 % of the tumors were able to be removed en-bloc. However, submucosal dissection EMR using an IT knife is technically difficult. Actually, in 14 % of the cases, the procedure took over 2 hours. Also major complications such as perforation and bleeding occurred in 4 % and 2 %, respectively. Although submucosal dissection EMR proved effective for a large percentage of cases, considering the high level of skill required, it is obvious that efforts should be made to develop safe and easy techniques.

 1) Endoscopy Division, National Cancer Center Hospital, Tokyo

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