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Endoscopic submucosal dissection for esophageal granular cell tumor using the clutch cutter

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Author(s): Keishi Komori | Kazuya Akahoshi | Yoshimasa Tanaka | Yasuaki Motomura | Masaru Kubokawa | Soichi Itaba | Terumasa Hisano | Takashi Osoegawa | Naotaka Nakama | Risa Iwao | Masafumi Oya | Kazuhiko Nakamura

Journal: World Journal of Gastrointestinal Endoscopy
ISSN 1948-5190

Volume: 4;
Issue: 1;
Start page: 17;
Date: 2012;
Original page

Keywords: Endoscopic submucosal dissection | Esophageal granular cell tumor | Clutch Cutter | Endoscopic therapy | Grasping type scissors forceps

ABSTRACT
Endoscopic submucosal dissection (ESD) with a knife is a technically demanding procedure associated with a high complication rate. The shortcomings of this method are the deficiencies of fixing the knife to the target lesion, and of compressing it. These shortcomings can lead to major complications such as perforation and bleeding. To reduce the risk of complications related to ESD, we developed a new grasping type scissors forceps (Clutch CutterĀ®, Fujifilm, Japan) which can grasp and incise the targeted tissue using an electrosurgical current. Esophagogastroduodenoscopy on a 59-year-old Japanese man revealed a 16mm esophageal submucosal nodule with central depression. Endoscopic ultrasonography demonstrated a hypoechoic solid tumor limited to the submucosa without lymph node involvement. The histologic diagnosis of the specimen obtained by biopsy was granular cell tumor. It was safely and accurately resected without unexpected incision by ESD using the CC. No delayed hemorrhage or perforation occurred. Histological examination confirmed that the granular cell tumor was completely excised with negative resection margin.We report herein a case of esophageal granular cell tumor successfully treated by an ESD technique using the CC.
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