Endoscopy 2013; 45(09): 725-728
DOI: 10.1055/s-0033-1344215
Innovations and brief communications
© Georg Thieme Verlag KG Stuttgart · New York

Endoscopic submucosal dissection using a thulium laser: preliminary results of a new method for treatment of gastric epithelial neoplasia

Jun-Hyung Cho
1  Institute for Digestive Research, Digestive Disease Center, Soonchunhyang University Hospital, Seoul, Korea
,
Joo Young Cho
1  Institute for Digestive Research, Digestive Disease Center, Soonchunhyang University Hospital, Seoul, Korea
,
Mi-Young Kim
1  Institute for Digestive Research, Digestive Disease Center, Soonchunhyang University Hospital, Seoul, Korea
,
Seong Ran Jeon
1  Institute for Digestive Research, Digestive Disease Center, Soonchunhyang University Hospital, Seoul, Korea
,
Tae Hee Lee
1  Institute for Digestive Research, Digestive Disease Center, Soonchunhyang University Hospital, Seoul, Korea
,
Hyun Gun Kim
1  Institute for Digestive Research, Digestive Disease Center, Soonchunhyang University Hospital, Seoul, Korea
,
So Young Jin
2  Department of Pathology, Soonchunhyang University Hospital, Seoul, Korea
,
Su Jin Hong
3  Digestive Disease Center, Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon, Korea
› Author Affiliations
Further Information

Publication History

submitted 24 December 2012

accepted after revision 28 April 2013

Publication Date:
24 July 2013 (online)

Background and study aim: This study aimed to evaluate the feasibility of a novel laser system for endoscopic submucosal dissection (ESD) of gastric epithelial neoplasia.

Patients and methods: A total of 10 patients underwent ESD by a single expert endoscopist. A thulium 2-μm wavelength laser system was used for ESD procedures. Instead of using endoscopy knives, a 550-μm flexible silica fiber was inserted through the working channel of the endoscope.

Results: In all patients, ESD was completed using only the thulium laser, without the need for endoscopy knives. The median total procedure time was 49 minutes (range 35 – 203). In 8 /10 patients (80 %), no active bleeding was observed during ESD. The final pathologic mapping revealed low-grade dysplasia (n = 4), differentiated adenocarcinoma (n = 5), and signet ring cell carcinoma (n = 1). Curative resection was achieved in 9 /10 patients (90 %). There were no significant complications, such as delayed bleeding or perforation.

Conclusions: The thulium laser system was feasible in ESD of gastric epithelial neoplasia.