endoscopic mucosal resection

Unwilling or intolerable early esophageal cancer and gastric cancer, broad-based benign polyps, small intraluminal smooth muscle tumors. Treatment of diseases: gastric cancer and esophageal cancer Indication Unwilling or intolerable early esophageal cancer and gastric cancer, broad-based benign polyps, small intraluminal smooth muscle tumors. Contraindications Progressive gastric cancer, with contraindications for gastroscopy, combined with extraluminal leiomyoma. Preoperative preparation 1. The patient is prepared to be the same as the preparation for endoscopic upper gastrointestinal polypectomy. 2. For equipment and medicine preparation, special endoscopic high-frequency generator, electric biopsy forceps, electric cuff holder, mucosal resection applicator, biopsy forceps and endoscope special injection needles are required for the endoscope; Bacterial saline and HSE solution. Surgical procedure 1. After injection of saline and endoscopic examination, the lesions were injected into the base of the tumor by endoscopic injection to induce the lesions (including the type IIc depression). Then, the coagulation is performed by a snare, and after the resection, if there is no active bleeding in the wound, the excised specimen is collected for pathological examination, that is, the operation is completed. 2. Lifting and cutting method This method requires the use of a double-hole surgical gastroscope. After the routine examination reveals the cancerous lesion, first use the biopsy forceps to lift the lesion, and then use the snare to cover the base of the lesion, electrify the resection, or use a double snare to cut. If there is no bleeding after resection, the removal of the specimen will complete the operation. 3. The endoscope end of the negative pressure suction method is covered with a plastic mucous membrane removal device, and then fixed from the biopsy hole to the end of the appendage through a matching electric snare. Align the lesion with negative pressure to draw the mucous membrane into the plastic applicator, tighten the snare (do not use excessive force), return the mucous membrane to the cavity, and cut the inhaled mucosa with high frequency electricity. After the resection, if there is no bleeding on the wound surface, collect the specimen to complete the operation. 4. Inject HSE sleeve cutting method to find the lesion under the direct vision of the endoscope, and make a pigment spray to confirm the lesion. The HSE solution was injected in the same manner as the injection saline method.

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