1994 Volume 44 Pages 73-76
We have already introduced an endoscopic mucosal resection using a cap-fitted panendoscope (EMRC) , and this time we developed a pre-looped cap which has a hook at the tip of the cap to simplify the snaring.
EMRC-cap is fitted at the tip of the panendoscope. More than 10 ml of saline solution mixed with low-volume epinephrine is injected into the submucosal layer around the lesion. A fine snare is passed through the biopsy channel of the endoscope, and is pre-looped at the tip of the cap using the hook. Under full endoscopic suction, the lesion-involved mucosa is packed into the cap, and then snared tightly. And then mucosal resection is performed with high-frequency electrocautery.
Eleven patients with 12 gastric lesions were treated with this EMRC procedure using a pre-looped cap. Twelve lesions consist of 7 early cancers (4 IIa types, 1 IIa+IIc type, 1 IIc type, 1 IIb type) , 4 adenomas, and 1 hyperplastic polyp. Almost all lesions were resected without any complication. Only one case had remnant cancer, and underwent laser therapy.
We believe that EMRC using a pre-looped cap is a simple and useful method of treatment for tumorous mucosal lesions of the stomch.
