title: A new method of EMR: submucosal injection of a fibrinogen mixture.
abstract: BACKGROUND
  The technical limitation associated with submucosal injection of normal saline solution during EMR is the relatively short duration of mucosal elevation. The clinical application of a new method of EMR with submucosal injection of a fibrinogen mixture was evaluated.
  
  
  METHODS
  Thirty-five early stage neoplastic gastric lesions were resected by EMR with submucosal injection of a fibrinogen mixture. The efficacy and clinical outcomes were analyzed.
  
  
  RESULTS
  Additional submucosal injection was not required for any of the 35 lesions to complete the EMR with submucosal injection of a fibrinogen mixture procedure. The rates of en bloc resection and complete resection were, respectively, 82.9% and 88.6%. The en bloc resection rate was significantly lower for lesions over 20 mm in diameter (60% vs. 92%; p<0.05) and for lesions on the lesser curvature or posterior wall of the stomach compared with those on the greater curvature or anterior wall (55.6% vs. 92.3%; p<0.05). The rate of complete resection also was dependent on the size and location of the lesions. There was no major EMR with submucosal injection of a fibrinogen mixture related complication including bleeding or perforation.
  
  
  CONCLUSIONS
  EMR with submucosal injection of a fibrinogen mixture is an easy, safe, and technically efficient method for complete EMR.
authors.affiliation: Department of Internal Medicine, Soon Chun Hyang University College of Medicine, Cheonan Hospital, Cheonan, Korea.
authors.forename: Suck-Ho
authors.initials: SH
authors.lastname: Lee
authors.forename: Won-Young
authors.initials: WY
authors.lastname: Cho
authors.forename: Hyun-Jun
authors.initials: HJ
authors.lastname: Kim
authors.forename: Hong-Joo
authors.initials: HJ
authors.lastname: Kim
authors.forename: Young-Hoon
authors.initials: YH
authors.lastname: Kim
authors.forename: Il-Kwun
authors.initials: IK
authors.lastname: Chung
authors.forename: Hong-Soo
authors.initials: HS
authors.lastname: Kim
authors.forename: Sang-Heum
authors.initials: SH
authors.lastname: Park
authors.forename: Sun-Joo
authors.initials: SJ
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005340:Fibrinogen / Q000008:administration & dosage*; D005753:Gastric Mucosa / Q000601:surgery*; D005773:Gastroscopy; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000473:pathology*
chemical_list: D005340:Fibrinogen