In order to expand the availability of endoscopic submucosal dissection (ESD), measures to facilitate the procedure are necessary. When bleeding occurs, the examiner's field of vision is critically impaired, and ESD becomes less efficient and more hazardous because of the presence of submucosal hematoma and covered blood clot. We propose the use of polyethylene glycol (PEG) irrigation as a simp...

BACKGROUND AND AIMS  Endoscopic resection techniques require use of submucosal injection. The aim of this study was to assess a new solution that combines hyaluronic acid, chondroitin sulfate, and poloxamer 407 for submucosal injection. METHODS  A total of 48 gastric submucosal cushions were created in fresh porcine stomachs using gelafundin (n = 16) or the new solution diluted at 50 % (n = 1...

BACKGROUND/AIMS Endoscopic submucosal dissection (ESD) allows removal of colorectal epithelial neoplasms en bloc regardless of size. Colorectal ESD is a difficult procedure because of technical difficulties and risks of complications. This study aimed to assess the relationship between ESD outcome and degree of submucosal fibrosis. METHODS Patients with colorectal tumors undergoing ESD and th...

We report repeated perforations during colorectal endoscopic submucosal dissection (ESD) and successful endoscopic closure. A 72-year-old man with a laterally spreading tumor, 25mm in diameter, in the lower rectum was referred for ESD. ESD was started from the anal side using a DualKnifeJ (Olympus, Tokyo, Japan). The lesion had severe fibrosis in the submucosal layer. The submucosal layer was n...

A submucosal lesion, more appropriately a subepithelial lesion, is hard to diagnose. Endoscopic ultrasonography is good to differentiate the nature of submucosal lesion. For definite diagnosis, tissue acquisition from submucosal lesion is necessary, and many methods have been introduced for this purpose mainly by endoscopic ultrasonography, such as endoscopic ultrasound-guided fine needle aspir...

  Lipomas of the gasterointestinal Tract are relatively uncommon in clinical practice. Most cases are asymptomatic with small tumor size and do not need any special treatment but the large ones are known to cause symptoms such as abdominal pain, obstruction, intussusceptions, and bleeding. The majority (90%) of these lesions are submucosal with predominantly right sided with a slight preponder...

A 45-year-old woman had refractory Epstein–Barr virus-associated gastroparesis. Despite lifestyle modification and medication therapy, the patient had recurrent hospitalizations for gastroparesis. Management also included four previous sessions of endoscopic botulinum toxin injection. Despite transient symptomatic improvement, the patient’s symptoms had recurred. She was not a candidate for sur...

Capsaicin-sensitive extrinsic sensory nerves and submucosal vasodilator neurons provide important vasodilator input to submucosal arterioles, but relatively little is known about the signaling between these populations and the sympathetic vasoconstrictor innervation. This study examined whether release of sympathetic purines can modulate dilator nerves. In vitro submucosal preparations from gui...

Endoscopic submucosal dissection (ESD) procedure is composed of circumferential mucosal incision and submucosal dissection. A variety of endoscopic accessories are required to perform mucosal incision and submucosal dissection safely. As a result of the improvements in ESD devices and peripheral equipment and development of the ESD technique, ESD procedures have been performed extensively world...

Background and aims: The increasing use of endoscopic resection for curative treatment of early oesophageal cancers requires accurate staging before therapy. In a prospective blinded trial, we compared staging of early oesophageal carcinoma using high resolution endoscopy (HR-E) with staging using high resolution endosonography (HR-EUS). Patients and methods: A total of 100 patients (89 men, 11...