title: Endoscopic mucosal resection, endoscopic submucosal dissection, and beyond: full-layer resection for gastric cancer with nonexposure technique (CLEAN-NET).
abstract: Mucosal cancer in the gastrointestinal tract generally has low risk of lymph node metastasis. Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are techniques of local excision of neoplasia confined to the mucosal layer. Specimens from EMR/ESD contribute to several diagnoses, and histologic results affect treatment decisions. A combined laparoscopic and endoscopic approach to neoplasia with a nonexposure technique allows full-thickness resection of the stomach wall without exposing the gastric lumen to the peritoneal cavity, preventing cancer cell dissemination to the peritoneal cavity. This article reviews EMR/ESD and describes a new full-thickness resection method using the nonexposure technique (CLEAN-NET).
authors.affiliation: Showa University International Training Center for Endoscopy, Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan. haruinoue777@yahoo.co.jp
authors.forename: Haruhiro
authors.initials: H
authors.lastname: Inoue
authors.forename: Haruo
authors.initials: H
authors.lastname: Ikeda
authors.forename: Toshihisa
authors.initials: T
authors.lastname: Hosoya
authors.forename: Akira
authors.initials: A
authors.lastname: Yoshida
authors.forename: Manabu
authors.initials: M
authors.lastname: Onimaru
authors.forename: Michitaka
authors.initials: M
authors.lastname: Suzuki
authors.forename: Shin-ei
authors.initials: SE
authors.lastname: Kudo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy / Q000295:instrumentation / Q000379:methods; D019160:Endosonography / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D005260:Female; D005753:Gastric Mucosa / Q000601:surgery*; D020699:Gastroscopes; D005773:Gastroscopy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000601:surgery*; D013525:Surgical Instruments; D017792:Surgical Stapling / Q000379:methods; D013536:Suture Techniques