A new method of EMR: submucosal injection of a fibrinogen mixture.
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.
Lee
Suck-Ho
SH
Department of Internal Medicine, Soon Chun Hyang University College of Medicine, Cheonan Hospital, Cheonan, Korea.
Cho
Won-Young
WY
Kim
Hyun-Jun
HJ
Kim
Hong-Joo
HJ
Kim
Young-Hoon
YH
Chung
Il-Kwun
IK
Kim
Hong-Soo
HS
Park
Sang-Heum
SH
Kim
Sun-Joo
SJ
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*
D005340:Fibrinogen