Endoscopic instruments and techniques in endoscopic submucosal dissection for early gastric cancer

Mitsuru Esaki, Eikichi Ihara, Takuji Gotoda

研究成果: Contribution to journalReview article査読

抄録

Introduction: Endoscopic submucosal dissection (ESD) is a less invasive local treatment for early gastric cancer (EGC). Areas covered: Japanese guidelines have recently expanded the endoscopic treatment indications for EGC. ESD is sometimes performed for lesions with a relative indication that has not previously been considered for ESD. ESD procedures are technically difficult, especially for larger and more invasive lesions. Complete resection and accurate histological assessment of EGC lesions are essential to evaluate endoscopic curability. Various endoscopic instruments, including three types of endoscopic knives and specific hemostatic forceps, have been developed, and endoscopic techniques, including the traction method, have been modified to simplify the procedure. Expert opinion: An insulated-tip knife with large tissue contact allows us to perform faster incisions, while a needle-type knife with minimal tissue contact allows us to perform precise incisions. Furthermore, a scissor-type knife with grasping tissues allows us to perform more secure incision. The traction method enables the operator to proceed with submucosal dissection procedures. In cases with small lesions, snaring can be used, as well as knife dissection. Understanding the features of each endoscopic instrument and technique is essential because appropriate selection and usage contribute to successful and safe ESD procedures.

本文言語英語
ページ(範囲)1009-1020
ページ数12
ジャーナルExpert Review of Gastroenterology and Hepatology
15
9
DOI
出版ステータス出版済み - 2021

All Science Journal Classification (ASJC) codes

  • 肝臓学
  • 消化器病学

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