A 63-year-old man visited our hospital because of a positive fecal occult blood test during mass screening. Total colonoscopy was performed, and a lateral spreading tumor (LST) about 30 mm in size was found at the cecum. The tumor was treated with en bloc resection by endoscopic submucosal dissection (ESD) using a hook knife. Pathological findings revealed that the tumor was a well-differentiated adenocarcinoma in adenoma, limited to the mucosa. He left our hospital 3 days after ESD without complications, such as perforation or delayed bleeding. If we are familiar with the characteristics of the endo-knives and know the location of the lesion, we can safely and accurately perform ESD.
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