Endoscopic Mucosal Resection of Superficial Cancer in the Stomach Using the Cap Technique

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Abstract
Clinicopathological analyses of surgically treated early gastric cancers have revealed that some of them would have been curable by endoscopic treatment. The main endoscopic treatment currently used for early gastric cancer is endoscopic mucosal resection (EMR), which allows histopathological examination of the resected specimen. It was first described by Deyhle et al. [ 1 ] in 1973 and the procedure was established by Tada et al. [ 2 ] in the 1980s under the name of strip biopsy. Since then various techniques of EMR for early gastric cancer have been reported, including endoscopic double-snare polypectomy (EDSP) [ 3 ], endoscopic resection following local injection of hypertonic saline-epinephrine (ERHSE) solution [ 4 ], strip biopsy [ 5 ], EMR using a cap-fitted panendoscope (EMRC) [ 6 ], and EMR using an insulated-tip diathermy knife [ 7 ]. In this report, the procedure and the results of EMRC for early gastric cancer are described. We are placing the emphasis on EMRC, because it is the most popular technique and does not require complex accessories. It is technically easier and less time-consuming. All the technical terms used in this report are in accordance with the Japanese Classification of Gastric Carcinoma [ 8 ].

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