ENDOSCOPIC MUCOSAL RESECTION AND SUBMUCOSAL DISSECTION METHOD FOR LARGE COLORECTAL TUMORS

  1. Yasushi Sano1,*,
  2. Hirohisa Machida1,
  3. Kuang-I. Fu1,
  4. Hiroaki Ito1,
  5. Takahiro Fujii2

Article first published online: 5 JUL 2004

DOI: 10.1111/j.1443-1661.2004.00375.x

Issue

Digestive Endoscopy

Digestive Endoscopy

Volume 16, Issue Supplement s1, pages S93–S96, July 2004

Additional Information

How to Cite

Sano, Y., Machida, H., Fu, K.-I., Ito, H. and Fujii, T. (2004), ENDOSCOPIC MUCOSAL RESECTION AND SUBMUCOSAL DISSECTION METHOD FOR LARGE COLORECTAL TUMORS. Digestive Endoscopy, 16: S93–S96. doi: 10.1111/j.1443-1661.2004.00375.x

Author Information

  1. 1

    Division of Digestive Endoscopy and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Chiba,

  2. 2

    TF Clinic, Ginza, Tokyo, Japan

*Yasushi Sano, Division of Digestive Endoscopy and Gastrointestinal Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa-city, Chiba, 277-8577, Japan. Email: ysano@east.ncc.go.jp

Publication History

  1. Issue published online: 5 JUL 2004
  2. Article first published online: 5 JUL 2004

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Keywords:

  • large flat-elevated;
  • sessile colorectal tumor;
  • laterally spreading tumor;
  • endoscopic mucosal resection;
  • submucosal dissecting method;
  • insulation-tipped electrosurgical knife

ABSTRACT

The goal of endoscopic mucosal resection (EMR) is to allow the endoscopist to obtain tissue or resect lesions not previously amenable to standard biopsy or excisional techniques and to remove malignant lesions without open surgery. In this article, we describe the results of conventional EMR and EMR using an insulation-tipped (IT) electrosurgical knife (submucosal dissection method) for large colorectal mucosal neoplasms and discuss the problems and future prospects of these procedures. At present, conventional EMR is much more feasible than EMR using IT-knife from the perspectives of time, money, complication, and organ preservation. However, larger lesions tend to be resected in a piecemeal fashion; and it is difficult to confirm whether EMR has been complete. For accurate histopathological assessment of the resected specimen en bloc EMR is desirable although further experience is needed to establish its safety and efficacy. Further improvements of in EMR with special knife techniques are required to simply and safely remove large colorectal neoplasms.

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