2001 Volume 43 Issue 9 Pages 1821-1827
Aim: To evaluate the effectiveness of the scratch-stick-method for endoscopic mucosal resection (EMR) of colorectal tumors (superficial type and nodule aggregating type) 20mm or more in size. Material and methods: Twenty lesions which were resected by the scratch-stick-method were reviewed as to the following points: 1) number of resections, 2) histological condition of the horizontal and vertical cut ends of resected specimens, 3) residue/recurrence of neoplasms at the site of resection, and 4) complications. Thirty-four lesions, resected by ordinary EMR, were also reviewed as a control. The scratch-stick-method is carried out as follows. First, a scratch is made by electrocautery in the normal mucosa oral to the lesion. After the tip of a snare has been stuck into the scratch to stabilize the snare, EMR is performed. Results: Complete resection in one session was achieved in 65% of the lesions which underwent EMR with the scratch-stick-method and in 35% of the lesions which underwent ordinary EMR. Neoplastic cells were observed at the horizontal cut end of the lesions in 5% of the group which underwent EMR with the scratch-stick-method and in 26% of the control group. No recurrence at the site of EMR was seen in the group which underwent EMR with the scratch-stick-method. No severe complications were observed in either group. Conclusion: The scratch-stick-method is a useful technique when performing EMR for large colorectal tumors.
