A new technique for endoscopic submucosal dissection for early gastric cancer using an external grasping forceps
A new technique for endoscopic submucosal dissection for early gastric cancer using an external grasping forceps
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DOI：
10.1055/s-2006-925264
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发表时间：
2006-10-01
期刊：
影响因子：
9.3
通讯作者：
Hibi, T.
中科院分区：
文献类型：
--
作者：
Imaeda, H.;Iwao, Y.;Hibi, T.
背景与研究目的：内镜下粘膜下剥离（ESD）治疗早期胃癌（EGC）提高了整体切除的成功率。我们在此报告一种使用外抓钳的新技术。患者和方法：共纳入25例胃体直径大于10mm的合适EGCs患者。在粘膜下注射后，用针刀对病变进行包皮环切，在第二钳的帮助下引入外部钳并锚定在病变远端边缘。用该钳进行温和的口腔牵引，在内窥镜下从胎儿侧逆行切除病变。结果：平均病灶大小为15.0 mm（范围10 ~ 25mm）。使用所描述的技术，所有病变都可以切除，并留有游离边缘。平均手术时间为45分钟（范围30 - 80分钟）。无明显出血需要输血或穿孔发生。结论：除远端病变外，该技术改良可简化和缩短胃ESD手术过程，且不影响疗效。
Background and Study Aims: Endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) has improved the success rate of en-bloc resection. We report here on a new technique using an external grasping forceps.Patients and Methods: A total of 25 patients with suitable EGCs over 10 mm in diameter located in the gastric body were enrolled. After submucosal injection followed by circumcision of the lesion with a needle-knife, an external grasping forceps was introduced with the help of a second grasping forceps and anchored at the distal margin of the lesion. With gentle oral traction applied with this forceps, the lesion was dissected endoscopically in retroversion from the aboral side.Results: The mean lesion size was 15.0 mm (range 10 - 25 mm). Using the technique described, all lesions could be resected en bloc with free margins. The mean procedure time was 45 min (range 30 - 80 minutes). No significant bleeding requiring blood transfusion or perforation occurred.Conclusions: This technical modification may simplify and shorten the gastric ESD procedure, except for lesions in distal locations, without compromising the efficacy.