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Merits and Demerits of Endoscopic Submucosal Dissection Using a Flex Knife Naohisa Yahagi 1 , Mitsuhiro Fujishiro 1 , Naomi Kakushima 1 , Atsushi Imagawa 1 , Mikitaka Iguchi 1 1Department of Gastroenterology, Faculty of Medicine, the University of Tokyo Keyword: 細径スネア , フレックスナイフ , EMR , 切開・剥離法 , 一括切除 pp.39-43
Published Date 2004/1/25
DOI https://doi.org/10.11477/mf.1403100410
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 A flex knife, which is an improvement of the thin-type snare, is flexible and offers good maneuverability. It is possible to cut in any direction under direct vision. Therefore, it is the most suitable instrument for beginners of endoscopic submucosal dissection (ESD). Furthermore, the tip forms a loop, and its length is adjustable, which reduces the risk of perforation during ESD. Using either the thin-type snare or the flex-knife, 198 lesions were treated by ESD. The overall successful en-bloc resection rate was 92%. Though perforation was observed in 8 cases (4%)and post-operative bleeding occurred in 3 cases (1.5%), all patients recovered under conservative therapy. ESD requires skill and much time, but enables definite en-bloc resection. To obtain radical curability and prevent local recurrence from remnant tissues, ESD is the most suitable technique among those available for endoscopic resection.

 1) Department of Gastroenterology, Faculty of Medicine, the University of Tokyo, Tokyo


Copyright © 2004, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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