Endoscopy 2003; 35(8): 690-694
DOI: 10.1055/s-2003-41516
Case Report

© Georg Thieme Verlag Stuttgart · New York

Successful En-Bloc Resection of Large Superficial Tumors in the Stomach and Colon Using Sodium Hyaluronate and Small-Caliber-Tip Transparent Hood

H.  Yamamoto1 , H.  Kawata1 , K.  Sunada1 , A.  Sasaki1 , K.  Nakazawa1 , T.  Miyata1 , Y.  Sekine1 , T.  Yano1 , K.  Satoh1 , K.  Ido1 , K.  Sugano1
  • 1Dept. of Gastroenterology, Jichi Medical School, Tochigi, Japan
Further Information

Publication History

Submitted 4 September 2002

Accepted after Revision 16 December 2002

Publication Date:
20 August 2003 (online)

En-bloc resection is desirable for accurate histopathological assessment of tissue specimens obtained using endoscopic mucosal resection (EMR). A new EMR method using sodium hyaluronate and a small-caliber-tip transparent hood has been developed. This is a peeling-off method using a needle-knife for mucosal and submucosal incisions. Long-lasting submucosal thickening resulting from an injection of sodium hyaluronate, and good visualization of the submucosal tissue with the aid of a small-caliber-tip transparent hood, make the cutting procedures easy and safe. A large superficial gastric cancer and a large villous tumor of the sigmoid colon were endoscopically resected using this method. En-bloc endoscopic resection was successful in both patients. The gastric lesion was an well-differentiated intramucosal adenocarcinoma, completely resected in a specimen measuring 97 × 50 mm. The colonic lesion was an intramucosal well-differentiated adenocarcinoma in adenoma, completely resected in a specimen measuring 70 × 55 mm in diameter. No significant complications were noted in either patient. The new method of EMR using sodium hyaluronate and the small-caliber-tip transparent hood is a promising method for endoscopic en-bloc resection of large superficial neoplastic lesions, both in the stomach and the colon.


H. Yamamoto, M.D.

Dept. of Gastroenterology · Jichi Medical School

Yakushiji, Minamikawachi · Tochigi 329-0498 · Japan

Fax: +81-285-44-8297

Email: yamamoto@jichi.ac.jp