Newly designed soft prelooped cap for endoscopic mucosal resection of gastric lesions.
BACKGROUND
Endoscopic mucosal resection with a cap-fitted panendoscope is a useful, effective, and safe technique. The effectiveness and safety of a newly designed larger but softer cap was compared in this study with the conventional hard cap. The soft cap has a significantly larger diameter (18 mm) compared with that of the hard cap (16.5 mm).


METHODS
Eighty-three patients who underwent mucosal resection of gastric lesions were included in analysis. The diameter, resection specimen depth, and the rate of en bloc resection were compared. The operability of the endoscope with the cap attached, patient tolerance, and safety of the procedure were analyzed.


RESULTS
Mean diameter (+/- SEM) of specimens resected with the soft cap was larger: 22.1 (+/- 0.7) versus 15.8 (+/- 0.3) mm (p < 0.001). The specimen was also thicker: 1.54 (+/- 0.10) versus 1.08 (+/- 0.11) mm (p < 0.001). Use of the soft cap led to higher rate of en bloc resection: 66.7% versus 43.2% (p < 0.05). The operability of the endoscope with the larger, softer cap attached was similar to that when the hard cap was used. Both caps were equally safe.


CONCLUSIONS
The soft cap is safe and useful for mucosal resection of larger gastric lesions. Its use increases the rate of en bloc resection.
Matsuzaki
Koji
K
Second Department of Internal Medicine, National Defense Medical College, Saitama, Japan.
Nagao
Shigeaki
S
Kawaguchi
Atsushi
A
Miyazaki
Junichi
J
Yoshida
Yukiko
Y
Kitagawa
Yoshitake
Y
Nakajima
Hiroyuki
H
Kato
Shingo
S
Hokari
Ryota
R
Tsuzuki
Yoshikazu
Y
Itoh
Kazuro
K
Niwa
Hirofumi
H
Miura
Soichiro
S
D000368:Aged; D015331:Cohort Studies; D004867:Equipment Design; D004869:Equipment Safety; D005260:Female; D005500:Follow-Up Studies; D005753:Gastric Mucosa / Q000473:pathology* / Q000601:surgery*; D020699:Gastroscopes; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D017060:Patient Satisfaction; D011336:Probability; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D013272:Stomach Diseases / Q000473:pathology / Q000601:surgery; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery*; D016896:Treatment Outcome