title: EMR of upper GI lesions when using a novel soft, irrigation, prelooped hood.
abstract: BACKGROUND
  EMR with a cap-fitted endoscope, including a soft, prelooped hood, is a useful, effective, and safe technique. One problem with this method, however, is that the lesion cannot always be kept in the center of the cap because the procedure is performed blindly after aspiration. A soft, prelooped hood with attached irrigation tube was developed. The usefulness of this device for EMR of upper-GI intramucosal cancers was evaluated.
  
  
  METHODS
  The end-hood piece was fabricated by drilling a side hole in the cap portion of a conventional soft, prelooped hood and then attaching an irrigation tube with glue to the exterior surface of the hole. The fabricated transparent hood was placed at the tip of an endoscope, and aspiration mucosectomy under irrigation was performed in 15 patients with upper-GI intramucosal cancer. When the field of view at the aspiration site was obscured by oozing blood, the site was irrigated.
  
  
  RESULTS
  A satisfactory view was obtained of all lesions. The mean diameter of specimens was 24.5 mm (interquartile range: 15-35). The proportion of en bloc resected lesions was 86.7% (13/15). Bleeding was the only complication (4/15; 26.7%) and was controlled by using endoscopic hemostatic techniques under irrigation.
  
  
  CONCLUSIONS
  EMR when using the soft, prelooped hood with irrigation tube is effective and safe for intramucosal cancers 20 mm or less in diameter.
authors.affiliation: Third Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyusyu, Japan.
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Kume
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yamasaki
authors.forename: Kiminori
authors.initials: K
authors.lastname: Kubo
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Mitsuoka
authors.forename: Takeshi
authors.initials: T
authors.lastname: Oto
authors.forename: Toru
authors.initials: T
authors.lastname: Matsuhashi
authors.forename: Takuji
authors.initials: T
authors.lastname: Yamasaki
authors.forename: Ichiro
authors.initials: I
authors.lastname: Yoshikawa
authors.forename: Makoto
authors.initials: M
authors.lastname: Otsuki
mesh_terms: D000368:Aged; D020776:Endoscopes, Gastrointestinal; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000601:surgery*