Successful en bloc resection of a large superficial gastric cancer by using sodium hyaluronate and electrocautery incision forceps

Background. The advisability of endoscopic mucosal resection (EMR) for trea tment of large superficial gastric cancers has been challenged. For more re liable en bloc resection, a new method of EMR was developed that uses a vis cous substance, sodium hyaluronate, and two newly designed devices. Methods: A large superficial gastric cancer was treated with this new EMR t echnique. Sodium hyaluronate was injected into the submucosa and mucosal in cisions were made with a needle-knife. The newly developed incision forceps and flat-ended transparent hood were used for submucosal incisions. Results. The large cancer was successfully resected endoscopically as a sin gle piece of mucosa 6 cm in diameter without complication. Histopathologic evaluation of the specimen confirmed that the resection was curative. Conclusions: EMR with sodium hyaluronate along with two new devices may be a reliable method for en bloc resection of large superficial gastric lesion s.