Insulated Tip Electrosurgical Knife를 이용한 내시경적 위점막 절제술

Abstract

Background/Aims: Endoscopic mucosal resection (EMR) has become a standard treatment for gastric mucosal neoplasm. A new EMR technique, using an insulated-tip electrosurgical knife (IT-EMR), was developed for large mucosal lesions. The aim of this study was to evaluate the efficacy and complication of IT-EMR. Methods: IT-EMR was performed for 28 gastric mucosal lesions in 27 patients. En bloc resection rate, complete resection rate and complications were evaluated. Results: IT-EMR was performed successfully in 27 lesions, and one lesion was failed because of the presence of a non-lifting sign. En bloc resections were achieved in 24 lesions (88.9%), and piecemeal resections in 3 lesions. Complete resections were achieved in 23 lesions (85.2%). There were 6 episodes (22%) of bleeding which were controlled completely by endoscopic treatment, and there was no perforation. Ten lesions (37%) were adenocarcinoma, 4 (14.8%) were high- grade dysplasia, and 12 (44.5%) were low-grade dysplasia. Conclusion: IT-EMR for large gastric mucosal neoplasm is a useful method for wide safety margin completeness of resection by en bloc resection. (Korean J Gastrointest Endosc 2003;26: 397⁣404)