Original articleClinical endoscopyProspective clinical trial of magnetic-anchor–guided endoscopic submucosal dissection for large early gastric cancer (with videos)
Section snippets
Patients
The purpose of this prospective clinical trial was to evaluate the feasibility of MAG-ESD. Twenty-five patients with EGC >20 mm diameter, located in the gastric body, were enrolled. The patients were first seen on an outpatient basis, and the tumor was assessed by a gastroscopy. From January 2005 to May 2006, all patients with EGC >20 mm in diameter, located in the gastric body, and with intestinal-type histology underwent an ESD on an inpatient basis at the National Cancer Center Hospital,
Results
The MAG-ESD technique was performed in 25 patients (M/F, 17/8; median age 70 years, range 48-85 years; median tumor size, 30 mm, range 20-70 mm).
The results of the MAG-ESDs are shown in Table 1. All tumors were resected en bloc, without any perforations or severe uncontrollable bleeding. The median size of resected specimen was 55 mm (33-125 mm). The median procedure time was 80 minutes (50-240 minutes). One resection was histologically confirmed as being noncurative because of deep submucosal
Discussion
The present study is, to our knowledge, the first clinical trial by using MAG-ESD for EGC in human beings. The feasibility of the technique for gastric cancer treatment was already evaluated in an animal study. The MAG-ESD technique permits excellent visualization of the submucosal layer, because it is possible to achieve suitable tissue tension. This simplifies a gastric ESD, even for large lesions located in the gastric body. The long-term exposure to the magnetic field did not cause any
Acknowledgments
We thank Professor Stefan Seewald (Department of Interdisciplinary Endoscopy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany) for his helpful suggestions for fluent medical English and encouragement with the preparation of the article.
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DISCLOSURE: The authors report that there are no disclosures relevant to this publication. This study was supported by a grant-in-aid for the Research on Advanced Medical Technology of the Ministry of Health, Labor and Welfare, and a grant-in-aid for the Third Term Comprehensive 10-year Strategy for Cancer Control, of the Ministry of Health, Labor and Welfare, Japan.