Outcome of endoscopic mucosal resection for early gastric cancer: review of the Japanese literature

Usefulness of a novel electrosurgical knife, the insulation-tipped diathermic knife-2, for endoscopic submucosal dissection of early gastric cancer

“…With regard to the safety issue, the rates of per-foration and postoperative hemorrhage did not differ between the two groups, although the IT-2 group consisted of more complicated cases. However, these rates of complications were apparently higher than those reported with conventional EMR, such as the strip biopsy method [9,10]. Nevertheless, perforations made by IT knives can usually be repaired endoscopically with endoclips (Olympus Medical Systems, Tokyo, Japan) [11], and we found, in the present study, that all the patients with postoperative hemorrhage could be conservatively treated, except for one patient who refused a nasogastric tube and for whom blood transfusion was necessary.…”

Frozen Section Analysis of Esophageal Endoscopic Mucosal Resection Specimens in the Real-Time Management of Barrett’s Esophagus

“…Lesions that penetrate below the muscularis mucosa should be treated with esophagectomy, but endoscopic treatment with EMR is not usually recommended for more invasive lesions because of potential metastases in more than 30% of patients. [11][12][13][14] During the past decade, EMR has gained acceptance in Europe and the United States as an alternative modality for the treatment of neoplastic lesions arising in the background of Barrett's esophagus. 3,4,15 Currently EMR and other endoluminal treatments for upper gastrointestinal neoplasia are accepted as alternatives for patients who are less than ideal candidates for esopha-gectomy.…”

Endoscopic mucosal resection in the upper and lower GI tract

“…Die Rate an R0-Resektionen bei gleichzeitiger en-bloc-Entfernung wird nicht angegeben (26). Auch neuere japanische Publikationen mit der Kappentechnik bei 106 Patienten mit Magenfrühkarzinom erzielten eine en-bloc-Resektion nur in 64% (Tumorgröße>15mm in 86%), und eine R0-Entfernung war naturgemäß bei der en-bloc-Technik häufiger als beim piecemeal-Verfahren (93% vs. 55%) (27) …”