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Endoscopic resection of esophageal leiomyoma with hypertonic saline epinephrine


Endoscopic resection of esophageal leiomyoma with hypertonic saline epinephrine



Gastroenterological Endoscopy 27(7): 1321-1330



The endoscopic resection method, which we developed for resection of early gastric cancer with local injection of Hypertonic Saline-Epinephrine (HS-E), was applied to esophageal leiomyoma and the tumor was safely resected. The suspected case was a 68 years old male who had a raised focus in the lower part of the esophagus, and was referred to our hospital for endoscopic resection. On the basis of X-ray, endoscope and CT findings, it was revealed that the disease was submucosal tumor of Yamada I type, which was an indication for endoscopic resection. The features of the method practiced this time were (1) the use of scalpel for endoscope was facilitated due to sufficient submucosal infusion of HS-E solution so that bleeding during/post-resection can be minimized, and (2) the mobilization of the tumor onto the mucous membrane with resultant easy snarling and easy resection of Yamada I type. The size of the resected sample was 10 .times. 8 .times. 6 mm, and the pathological diagnosis was esophageal leiomyoma. The patient scarcely showed bleeding during/post-resection, the no side effect of epinephrine was noted. Hence, this method is widely applicable to endoscopic resection and patho-histological diagnosis of submucosal tumor.

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