EFFECT OF ENDOSCOPIC MUCOSAL RESECTION ON SUBMUCOSAL BLOOD VESSELS OF THE STOMACH

-AN EXPERIMENTAL STUDY-

Abstract

Submucosal blood vessels of the stomach can be visualized by means of an inflared ray electronic endoscope. In the present experimental study the effect of endoscopic mucosal resection (EMR) on submucosal blood vessels of the stomach was explored by performing the surgical procedure under infrared ray electronic endoscopic vision. Ten adult dogs were used for the study. On infrared ray electronic endoscopy those submucosal blood vessels which were injured at the time of EMR and hence became the sources of hemor-rhage caused by EMR were visualized as an arborescent appearance of vessels, at around 2 mm in diameter, in C area. On microangiogram of the area where blood vessels were visualized by infrared ray electronic endoscopy, venules running transversely in the sub-mucosa before their portal of entry into the muscularis externa and an arteriole ac-companying them was found. When EMR was performed on the same mucosal area as described above and its injurious effect on the above-specified submucosal vessels was examined by microangiography, it became obvious that while a vascular injury caused by EMR involving a mucosal area <10 mm in longer diameter was slight, as high a vascular injury rate as 85.7% was noted for EMR involving a mucosal area >15 mm in longer diameter. Most of vascular injuries caused by EMR were accounted for by rupture of vessels running transversely in the submucosa at margins of the mucosal area undergoing EMR, although rupture of submucosal vessels in close proximity to their portal of entry into the muscularis externa was occasionally seen.