Endoscopic resection of early gastric cancer and other tumors with local injection of hypertonic saline-epinephrine

Hirao, Masanori; Masuda, Kazuhiko; Asanuma, Takeki; Naka, Hiroji; Noda, Kôichi; Matsuura, Kimio; Yamaguchi, Osaiumi; Ueda, Noriyuki

doi:10.1016/s0016-5107(88)71327-9

Cited by 365 publications

(222 citation statements)

References 2 publications

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“…Endoscopic submucosal dissection (ESD) for ESCNs is an endoluminal therapeutic technique to dissect directly along the submucosal layer. ESD was developed in Japan for the surgical treatment of gastric cancer and gave high curative resection rates for early gastric cancer, regardless of tumor size [18][19][20][21][22][23] . Hence, the technique has also been introduced for the esophagus [24] and was approved for the treatment of esophageal cancer by the Japanese government in 2008.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic submucosal dissection for superficial esophageal squamous cell neoplasms

Honda

Akiho

2012

WJGP

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Endoscopic resection is an effective treatment for noninvasive esophageal squamous cell neoplasms (ESCNs). Endoscopic mucosal resection (EMR) has been developed for small localized ESCNs as an alternative to surgical therapy because it shows similar effectiveness and is less invasive than esophagectomy. However, EMR is limited in resection size and therefore piecemeal resection is performed for large lesions, resulting in an imprecise histological evaluation and a high frequency of local recurrence. Endoscopic submucosal dissection (ESD) has been developed in Japan as one of the standard endoscopic resection techniques for ESCNs. ESD enables esophageal lesions, regardless of their size, to be removed en bloc and thus has a lower local recurrence rate than EMR. The development of new devices and the establishment of optimal strategies for esophageal ESD have resulted in fewer complications such as perforation than expected. However, esophageal stricture after ESD may occur when the resected area is larger than three-quarters of the esophageal lumen or particularly when it encompasses the entire circumference; such a stricture requires multiple sessions of endoscopic balloon dilatation.Recently, oral prednisolone has been reported to be useful in preventing post-ESD stricture. In addition, a combination of chemoradiotherapy (CRT) and ESD might be an alternative therapy for submucosal esophageal cancer that has a risk of lymph node metastasis because esophagectomy is extremely invasive; CRT has a higher local recurrence rate than esophagectomy but is less invasive. ESD is likely to play a central role in the treatment of superficial esophageal squamous cell neoplasms in the future.

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Section: Introductionmentioning

confidence: 99%

Endoscopic submucosal dissection for superficial esophageal squamous cell neoplasms

Honda

Akiho

2012

WJGP

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“…It may be necessary to lift the lesion with a forceps before it can be encircled completely with the snare. These features of this technique make the procedure extremely difficult to perform in certain anatomic locations and may cause it to be time-consuming, requiring the assistance of a skilled assistant [8].…”

Section: Introductionmentioning

confidence: 99%

Endoscopic mucosal resection using a cap-fitted endoscope improves tissue resection and pathology interpretation: an animal study

2006

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“…In this method, the flat lesion is changed to polypoid lesion by submucosal injection of mixture of normal saline with diluted epinephrine, and resected by grasper forcep and electrosurgical snare through 2-channel endoscope. Although this method had advantages of easy technique, short procedure time and less complication, complete resection rate was around 50 -70%, which was lower than expected for large-sized or depressed-type EGC (Hirao et al, 1988). In 1988, EMR-precutting method has been developed, in which after hypertonic saline with diluted epinephrine is injected to submucosal layer around the lesion, circumferential incision around the lesion with needle knife and final resection of the lesion is performed with electrosurgical snare.…”

Section: History Of Endoscopic Resection For Egcmentioning

confidence: 99%