Technique of endoscopic cardiac mucosectomy using a multipurpose tube

We devised a useful technique for endoscopic esophageal mucosectomy using a transparent overtube with negative pressure (np-EEM). Seventy-two patients with superficial esophageal diseases (80 lesions including 17 submucosal cancers) were treated by np-EEM from 1991. Six lesions were located on the cardiac region. The np-EEM technique near esophagogastric junction enabled us to achieve a wide (maximum 5.8x3.6 cm) mucosectomy in one piece. No perforations, uncontrollable bleeding, or stenosis occurred. The advantages of np-EEM are ease of handling, good positioning, relatively wide one-piece-resection, ease of repetitive resection, easy management of bleeding and applicability to all parts of the esophagus, The np-EEM is one of the most appropriate techniques of mucosectomy in the cardiac region.