Experimental assessment of endoscopic mucosectomy with a cap-fitted panendoscope

Background and Study Aims: The use of a cap-fitted panendoscope is one meth od of carrying out endoscopic mucosectomy in the esophagus, stomach, and la rge intestine. The purpose of this study was to determine the optimal volum e of physiological saline for submucosal injection, the rate of mucosal ext ension after saline injection, the initial size of the resected mucosal spe cimen, and the most appropriate heights for the fitted caps used in the col on and in the rectum, respectively, Methods: Endoscopic mucosectomies using cap-fitted panendoscopes were carri ed out on resected surgical specimens from ten patients with colorectal can cer, Results: It was necessary to inject 12 mi of saline under the mucosa to pre vent perforation. Submucosal saline injection extended the mucosa by 1.4 +/ - 0.2 times. A cap with a height of 7 mm is suitable for performing mucosec tomy in the colon safely, while both 7 mm and 10 mm caps can be used in the rectum, The initial size of the resected mucosal specimens obtained with b oth caps was 12-20 mm (mean 14 mm) in diameter, with no significant differe nces, As the sizes of resected mucosal specimens reported in the past have been obtained after submucosal saline injection, it appears that larger spe cimens can be resected with the cap-fitted panendoscope than with conventio nal methods. Conclusions: The conditions under which endoscopic mucosectomy using the ca p-fitted panendoscope can be performed safely in the colon and the rectum w ere suggested by this experimental study using resected specimens. A saline injection of 12 mi under the mucosa is necessary to prevent perforation, A cap with a height of 7 mm is the most suitable size for the colon, while b oth 7 mm and 10 mm caps can be used in the rectum.