7084 Endoscopic aspiration mucosectomy using a bipolar snare for gastric neoplasms.

PURPOSE: Although tissue damage is minimized using the bipolar snare, it is not widely used for endoscopic mucosal resection of the stomach because of slippage. The purpose of this study is to determine whether a bipolar snare can be used effectively for endoscopic mucosal resection of the stomach if aspiration is added to avoid slippage of the snare. METHODS: Patients with gastric adenoma or early gastric intestinal type adenocarcinoma were enrolled. Depressed lesions which were ulcerated or greater than 10 mm in diameter and elevated lesions greater than 20 mm in diameter were excluded. The utility of endoscopic aspiration mucosectomy using a bipolar snare (EAM-B) was examined retrospectively and compared with respect to specimen size, rate of complete resection, and occurrence of complication with endoscopic mucosal resection with a capfitted panendoscope using a monopolar snare (EMRC-M). RESULTS: EAM-B was performed in five lesions of five patients and EMRC-M was performed in five lesions of four patients. The resected specimen size was 20.0 ± 0.9 mm after EAM-B and 16.2 ± 4.5 mm after EMRC-M. There was no significant difference in the resected specimen size (P=0.0611) after EAM-B and EMRC-M. Complete resection was achieved in all cases. There were no complications. CONCLUSIONS: A bipolar snare can be used effectively for endoscopic mucosal resection of the stomach if aspiration is added to avoid slippage of the snare.