A case report of quadruple gastric mucosal lesions radically resected by the submucosal dissection method using a flex knife

Abstract

A recurrent mucosal cancer after endoscopic mucosal resection (EMR) was detected in a 68 year-old man at another hospital and he was informed of the necessity of a gastrectomy because the lesion had severe scarring due to the previous EMR. However, the patient was reluctant to undergo a gastrectomy and referred to our department. Endoscopy revealed other three mucosal tumors in the stomach, but we judged that those lesions could be successfully resected endoscopically, and the submucosal dissection EMR using a flex knife was perfomed all of the tumors without complications. The histological investigation of resected specimens revealed that those tumors were all completely resected, which meant that he did not have an additional gastrectomy. The artificial ulcers formed by EMR were cured within eight weeks without stenosis. This case shows the usefulness of the submucosal dissection EMR using a flex knife, which enables patients with recurrent tumors and multiple tumors like this patient to avoid an unnecessary gastrectomy and provide good quality of live.