title: Successful en-bloc resection of large superficial tumors in the stomach and colon using sodium hyaluronate and small-caliber-tip transparent hood.
abstract: En-bloc resection is desirable for accurate histopathological assessment of tissue specimens obtained using endoscopic mucosal resection (EMR). A new EMR method using sodium hyaluronate and a small-caliber-tip transparent hood has been developed. This is a peeling-off method using a needle-knife for mucosal and submucosal incisions. Long-lasting submucosal thickening resulting from an injection of sodium hyaluronate, and good visualization of the submucosal tissue with the aid of a small-caliber-tip transparent hood, make the cutting procedures easy and safe. A large superficial gastric cancer and a large villous tumor of the sigmoid colon were endoscopically resected using this method. En-bloc endoscopic resection was successful in both patients. The gastric lesion was an well-differentiated intramucosal adenocarcinoma, completely resected in a specimen measuring 97 x 50 mm. The colonic lesion was an intramucosal well-differentiated adenocarcinoma in adenoma, completely resected in a specimen measuring 70 x 55 mm in diameter. No significant complications were noted in either patient. The new method of EMR using sodium hyaluronate and the small-caliber-tip transparent hood is a promising method for endoscopic en-bloc resection of large superficial neoplastic lesions, both in the stomach and the colon.
authors.affiliation: Dept. of Gastroenterology, Jichi Medical School, Tochigi, Japan. yamamoto@jichi.ac.jp
authors.forename: H
authors.initials: H
authors.lastname: Yamamoto
authors.forename: H
authors.initials: H
authors.lastname: Kawata
authors.forename: K
authors.initials: K
authors.lastname: Sunada
authors.forename: A
authors.initials: A
authors.lastname: Sasaki
authors.forename: K
authors.initials: K
authors.lastname: Nakazawa
authors.forename: T
authors.initials: T
authors.lastname: Miyata
authors.forename: Y
authors.initials: Y
authors.lastname: Sekine
authors.forename: T
authors.initials: T
authors.lastname: Yano
authors.forename: K
authors.initials: K
authors.lastname: Satoh
authors.forename: K
authors.initials: K
authors.lastname: Ido
authors.forename: K
authors.initials: K
authors.lastname: Sugano
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D000368:Aged; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology / Q000601:surgery*; D006801:Humans; D006820:Hyaluronic Acid / Q000627:therapeutic use*; D008875:Middle Aged; D012811:Sigmoid Neoplasms / Q000473:pathology / Q000601:surgery*; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*
chemical_list: D000276:Adjuvants, Immunologic; D006820:Hyaluronic Acid