Four-Step Endoscopic Esophageal Mucosal Resection (EEMR) Tube Method of Resection for Early Esophageal Cancer

Objectives

Remarkable advances in endoscopic diagnosis have been made with the increasingly widespread use of high-resolution video endoscopy and chromoendoscopy. Clinicians are detecting increasing numbers of early and superficial malignant lesions not only in the stomach and intestines, but also in the esophagus. The same trend can be seen in adenocarcinoma detected in Barrett’s esophagus.

The standard curative surgical approach to esophageal cancer has been thoracotomy and laparotomy with extensive lymph-node dissection - an extremely invasive procedure that has a significant negative effect on the patient’s postoperative quality of life. As a result, there has been a growing need to develop a less invasive surgical therapeutic approach to early esophageal cancer without lymph-node metastasis.

The endoscopic mucosal resection (EMR) method for mucosal esophageal carcinoma was first developed in Japan in 1988 [1] [2]. The strip biopsy method, the endoscopic esophageal mucosal resection (EEMR) tube method [2], and the endoscopic mucosal resection cap (EMRC) method [3] developed rapidly and quickly came into widespread use [4] [5]. Recently, the hook-knife method [6] has been used to achieve incision and ablation of malignant lesions in one piece. We have also developed a four-step EEMR tube method that allows safe, easy, and reliable resection of the lesion [7]. This four-step method of EMR for early esophageal cancer is described here in detail.

References

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