Gastric cancer. EndoTODAY

[Gastric cancer 803. Small EGC treated with a hybrid knife made in Korea]

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ESD is a complex procedue. High quality instruments are critical for a successful endoscopic treatment. Recently, hybrid knives are actively developed by a various vendors.

Recently, I sometimes use H-type ESD knife from Finemedix company (located in Daegu). It has a I-tip (similar to Dual knife from Olympus) and O-tip (similar to IT-2 knife from Olympus) in a single catheter.

ESD : Early gastric carcinoma
1. Location : antrum, anterior wall
2. Gross type : EGC type IIc
3. Histologic type : tubular adenocarcinoma, moderately differentiated with focal clear cell change
4. Histologic type by Lauren : intestinal
5. Size of carcinoma : (1) longest diameter, 20 mm (2) vertical diameter, 8 mm
6. Depth of invasion : invades mucosa (muscularis mucosa) (pT1a)
7. Resection margin : free from carcinoma(N), safety margin : distal 11 mm, proximal 10 mm, anterior 8 mm, posterior 6 mm, deep 300
8. Lymphatic invasion : not identified(N)
9. Venous invasion : not identified(N)
10. Perineural invasion : not identified(N)
11. Pre-existing adenoma : none
12. Microscopic ulcer : absent
13. Histologic heterogeneity: absent