A NEW METHOD OF ENDOSCOPIC ESOPHAGEAL MUCOSAL RESECTION USING A TRANSPARENT TUBE (EMRT)

Abstract

Preoperative assessment of early esophageal cancer has been established mainly by evaluation of endoscopic and endoscopic ultrasonographic findings. It is necessary to devise so called large particle biopsy of the esophagus for accurate pathological diagnosis of the uncolored portion under the Lugol staining method and for a therapeutic approach to mucosal lesion of the esophagus. We deviced a new method of endoscopic esophageal mucosal resection using a trans-parent tube (EMRT). Thirty-seven specimens from 7 dogs were evaluated in relation to size of the resected specimens and histological depth of the artificial ulcer. As a result, resected specimens with size less than 10mm in the longitudinal axis were related to histological depth of the submucosal layer on single cautery of EMRT. With specimens up to this size, single cautery of EMRT is safely performed without the risk of perforation. Moreover, repeated cauteries of EMRT made extensive mucosal resection possible (extensive EMRT) in dogs. Using this technique, any amount and any part of esophageal mucosa can be resected. The recovery pattern of the artificial ulcer and the long-term complications of extensive esophageal mucosal resection remain to be clarified.