title: Endoscopic submucosal dissection for esophageal granular cell tumor using the clutch cutter.
abstract: Endoscopic submucosal dissection (ESD) with a knife is a technically demanding procedure associated with a high complication rate. The shortcomings of this method are the deficiencies of fixing the knife to the target lesion, and of compressing it. These shortcomings can lead to major complications such as perforation and bleeding. To reduce the risk of complications related to ESD, we developed a new grasping type scissors forceps (Clutch Cutter®, Fujifilm, Japan) which can grasp and incise the targeted tissue using an electrosurgical current. Esophagogastroduodenoscopy on a 59-year-old Japanese man revealed a 16mm esophageal submucosal nodule with central depression. Endoscopic ultrasonography demonstrated a hypoechoic solid tumor limited to the submucosa without lymph node involvement. The histologic diagnosis of the specimen obtained by biopsy was granular cell tumor. It was safely and accurately resected without unexpected incision by ESD using the CC. No delayed hemorrhage or perforation occurred. Histological examination confirmed that the granular cell tumor was completely excised with negative resection margin.We report herein a case of esophageal granular cell tumor successfully treated by an ESD technique using the CC.
authors.affiliation: Keishi Komori, Kazuya Akahoshi, Yoshimasa Tanaka, Yasuaki Motomura, Masaru Kubokawa, Soichi Itaba, Terumasa Hisano, Takashi Osoegawa, Naotaka Nakama, Risa Iwao, Department of Gastroenterology, Aso Iizuka Hospital, 3-83, Yoshio-machi, Iizuka, Fukuoka 820-8505, Japan.
authors.forename: Keishi
authors.initials: K
authors.lastname: Komori
authors.forename: Kazuya
authors.initials: K
authors.lastname: Akahoshi
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Motomura
authors.forename: Masaru
authors.initials: M
authors.lastname: Kubokawa
authors.forename: Soichi
authors.initials: S
authors.lastname: Itaba
authors.forename: Terumasa
authors.initials: T
authors.lastname: Hisano
authors.forename: Takashi
authors.initials: T
authors.lastname: Osoegawa
authors.forename: Naotaka
authors.initials: N
authors.lastname: Nakama
authors.forename: Risa
authors.initials: R
authors.lastname: Iwao
authors.forename: Masafumi
authors.initials: M
authors.lastname: Oya
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Nakamura