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World J Gastroenterol. Jul 21, 2014; 20(27): 9210-9214
Published online Jul 21, 2014. doi: 10.3748/wjg.v20.i27.9210
Published online Jul 21, 2014. doi: 10.3748/wjg.v20.i27.9210
Endoscopic submucosal tunnel dissection salvage technique for ulcerative early gastric cancer
Hyuk Soon Choi, Hoon Jai Chun, Min Ho Seo, Eun Sun Kim, Bora Keum, Yeon Seok Seo, Yoon Tae Jeen, Hong Sik Lee, Soon Ho Um, Chang Duck Kim, Ho Sang Ryu, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul 136-705, South Korea
Author contributions: Choi HS wrote the manuscript; Chun HJ designed the study and performed the ESD procedure; Seo MH, Kim ES, Keum B and Seo YS provided the illustration and figure images; Jeen YT, Lee HS and Um SH provided medical treatment and advice; Kim CD and Ryu HS conceptualized this work and provided advice.
Supported by Korea Healthcare Technology R and D Project, Ministry of Health and Welfare, South Korea, No. A111182; A grant from Korea University
Correspondence to: Hoon Jai Chun, MD, PhD, AGAF, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Korea University Medical Center, Inchon-ro 73, Seongbuk-gu, Seoul 136-705, South Korea. drchunhj@chol.com
Telephone: +82-2-9205699 Fax: + 82-2-9531943
Received: December 21, 2013
Revised: March 2, 2014
Accepted: March 19, 2014
Published online: July 21, 2014
Revised: March 2, 2014
Accepted: March 19, 2014
Published online: July 21, 2014
Core Tip
Core tip: The fibrosis found in ulcerative early gastric cancer (EGC) has been an obstacle to successful endoscopic submucosal dissection (ESD). This report demonstrates the first use of the endoscopic submucosal tunnel dissection (ESTD) salvage technique for treatment of ulcerative EGC with fibrosis. ESTD involves the use of an endoscopic cap under the tunnel flap, which enables a clear view of the submucosal dissection line, making it easier than conventional ESD to resect an EGC lesion without complication. Therefore, the ESTD salvage technique has several advantages for resection of EGC with severe fibrosis due to previous ESD or severe ulceration.