title: Endoscopic mucosal resection for early gastric cancer: comparison of two modifications of the cap method.
abstract: OBJECTIVE
  Endoscopic mucosal resection using a cap (EMR-C) is an established method for curative resection of early neoplastic lesions; prelooping of the snare may however be difficult and lead to imprecise resection. We therefore compared two modifications of the conventional technique using outer snare placement with an accessory channel in a prospective, nonrandomized study.
  
  
  METHODS
  Between October 2004 and March 2007, 54 patients (men 37, women 17; mean age 71 years) underwent EMR. One method involved an internally retained snare (IRS) cap, with a fixed prelooped snare inside the cap; the other method used an externally guided snare (EGS) cap with the snare guided over an oblique cap. The main outcome parameters were specimen size, en bloc resection, and complications.
  
  
  RESULTS
  There was no difference between use of the IRS and EGS cap methods in relation to specimen size (27.6 vs. 27.1 mm), or rates of en bloc resection (88.9 % vs. 83.3 %); only one perforation occurred, and this was in the EGS group.
  
  
  CONCLUSIONS
  Both techniques appeared to provide similar efficacy, the inner rim of the IRS cap stabilizes aspiration of the lesion compared with the EGS cap that does not have it.
authors.affiliation: Department of Gastroenterology and Metabolism, University of Occupational and Environmental Health, School of Medicine, Kitakyusyu, Japan. k-kume@med.uoeh-u.ac.jp
authors.forename: K
authors.initials: K
authors.lastname: Kume
authors.forename: M
authors.initials: M
authors.lastname: Yamasaki
authors.forename: M
authors.initials: M
authors.lastname: Tashiro
authors.forename: N
authors.initials: N
authors.lastname: Santo
authors.forename: K
authors.initials: K
authors.lastname: Syukuwa
authors.forename: S
authors.initials: S
authors.lastname: Maekawa
authors.forename: G
authors.initials: G
authors.lastname: Aritome
authors.forename: H
authors.initials: H
authors.lastname: Matsuoka
authors.forename: T
authors.initials: T
authors.lastname: Murase
authors.forename: I
authors.initials: I
authors.lastname: Yoshikawa
authors.forename: M
authors.initials: M
authors.lastname: Otsuki
mesh_terms: D000368:Aged; D004867:Equipment Design; D005260:Female; D005753:Gastric Mucosa / Q000601:surgery*; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D013274:Stomach Neoplasms / Q000601:surgery*; D016896:Treatment Outcome