Lee Suck-Ho, Cho Won-Young, Kim Hyun-Jun, Kim Hong-Joo, Kim Young-Hoon, Chung Il-Kwun, Kim Hong-Soo, Park Sang-Heum, Kim Sun-Joo
Department of Internal Medicine, Soon Chun Hyang University College of Medicine, Cheonan Hospital, Cheonan, Korea.
Gastrointest Endosc. 2004 Feb;59(2):220-4. doi: 10.1016/s0016-5107(03)02689-0.
The technical limitation associated with submucosal injection of normal saline solution during EMR is the relatively short duration of mucosal elevation. The clinical application of a new method of EMR with submucosal injection of a fibrinogen mixture was evaluated.
Thirty-five early stage neoplastic gastric lesions were resected by EMR with submucosal injection of a fibrinogen mixture. The efficacy and clinical outcomes were analyzed.
Additional submucosal injection was not required for any of the 35 lesions to complete the EMR with submucosal injection of a fibrinogen mixture procedure. The rates of en bloc resection and complete resection were, respectively, 82.9% and 88.6%. The en bloc resection rate was significantly lower for lesions over 20 mm in diameter (60% vs. 92%; p<0.05) and for lesions on the lesser curvature or posterior wall of the stomach compared with those on the greater curvature or anterior wall (55.6% vs. 92.3%; p<0.05). The rate of complete resection also was dependent on the size and location of the lesions. There was no major EMR with submucosal injection of a fibrinogen mixture related complication including bleeding or perforation.
EMR with submucosal injection of a fibrinogen mixture is an easy, safe, and technically efficient method for complete EMR.
