title: Endoscopic submucosal dissection using a thulium laser: preliminary results of a new method for treatment of gastric epithelial neoplasia.
abstract: OBJECTIVE
  This study aimed to evaluate the feasibility of a novel laser system for endoscopic submucosal dissection (ESD) of gastric epithelial neoplasia.
  
  
  METHODS
  A total of 10 patients underwent ESD by a single expert endoscopist. A thulium 2-μm wavelength laser system was used for ESD procedures. Instead of using endoscopy knives, a 550-μm flexible silica fiber was inserted through the working channel of the endoscope.
  
  
  RESULTS
  In all patients, ESD was completed using only the thulium laser, without the need for endoscopy knives. The median total procedure time was 49 minutes (range 35 - 203). In 8 /10 patients (80 %), no active bleeding was observed during ESD. The final pathologic mapping revealed low-grade dysplasia (n = 4), differentiated adenocarcinoma (n = 5), and signet ring cell carcinoma (n = 1). Curative resection was achieved in 9 /10 patients (90 %). There were no significant complications, such as delayed bleeding or perforation.
  
  
  CONCLUSIONS
  The thulium laser system was feasible in ESD of gastric epithelial neoplasia.
authors.affiliation: Institute for Digestive Research, Digestive Disease Center, Soonchunhyang University Hospital, Seoul, Korea.
authors.forename: Jun-Hyung
authors.initials: JH
authors.lastname: Cho
authors.forename: Joo Young
authors.initials: JY
authors.lastname: Cho
authors.forename: Mi-Young
authors.initials: MY
authors.lastname: Kim
authors.forename: Seong Ran
authors.initials: SR
authors.lastname: Jeon
authors.forename: Tae Hee
authors.initials: TH
authors.lastname: Lee
authors.forename: Hyun Gun
authors.initials: HG
authors.lastname: Kim
authors.forename: So Young
authors.initials: SY
authors.lastname: Jin
authors.forename: Su Jin
authors.initials: SJ
authors.lastname: Hong
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000236:Adenoma / Q000473:pathology / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D004210:Dissection / Q000295:instrumentation*; D005260:Female; D005753:Gastric Mucosa / Q000601:surgery*; D005773:Gastroscopy; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D013932:Thulium
chemical_list: D013932:Thulium