title: Endoscopic submucosal dissection using a grasping-type scissors forceps for early gastric cancers and adenomas.
abstract: OBJECTIVE
  To reduce the risk of complications related to endoscopic submucosal dissection (ESD) using knives, we developed a new grasping-type scissors forceps (GSF) that can grasp and incise the target tissue using electrosurgical current. The aim of the present study was to evaluate the efficacy and safety of ESD using GSF for the removal of early gastric cancers and adenomas.
  
  
  METHODS
  ESD using GSF was carried out on 35 consecutive patients with early gastric cancers or adenomas who had preoperative EUS diagnoses of mucosal tumor without lymph node involvement. Therapeutic efficacy and safety were assessed.
  
  
  RESULTS
  All lesions were treated easily and safely without unexpected incision. The mean size of epithelial tumors and resected specimens was 15.6mm and 32.7mm, respectively. Curative en-bloc resection rates according to tumor size and location were 96% (26/27) in tumors ≤20mm, 100% (8/8) in tumors >20mm, 100% (18/18) of tumors in the lower portion, 100% (8/8) of tumors in the middle portion, 89% (8/9) of tumors in the upper portion, and 97% (34/35) overall. The mean operating time according to tumor size and location was 93.4min in tumors ≤20mm, 140min in tumors >20mm, 77.6min for tumors in the lower portion, 113.4min for tumors in the middle portion, 148.6min for tumors in the upper portion, and 104.1min overall. No intraoperative complication occurred, and postoperative bleeding was seen in 3% (1/35).
  
  
  CONCLUSIONS
  ESD using GSF allows simple and safe en-bloc resection of early gastric cancer or adenoma irrespective of tumor size and location.
authors.affiliation: Department of Gastroenterology, Aso Iizuka Hospital, Iizuka, Japan. kakahoshi2@aol.com
authors.forename: Kazuya
authors.initials: K
authors.lastname: Akahoshi
authors.forename: Kuniomi
authors.initials: K
authors.lastname: Honda
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Motomura
authors.forename: Masaru
authors.initials: M
authors.lastname: Kubokawa
authors.forename: Risa
authors.initials: R
authors.lastname: Okamoto
authors.forename: Takashi
authors.initials: T
authors.lastname: Osoegawa
authors.forename: Naotaka
authors.initials: N
authors.lastname: Nakama
authors.forename: Yumi
authors.initials: Y
authors.lastname: Kashiwabara
authors.forename: Naomi
authors.initials: N
authors.lastname: Higuchi
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Masafumi
authors.initials: M
authors.lastname: Oya
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Nakamura
mesh_terms: D000236:Adenoma / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D004210:Dissection; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005753:Gastric Mucosa / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000601:surgery*; D013525:Surgical Instruments