Usefulness of Ultraslim Endoscopy with Flexible Spectral Imaging Color Enhancement for Detection of Gastric Neoplasm: A Preliminary Study

Abstract

Transnasal endoscopy with ultraslim endoscope has rapidly spread in Japan. Ultraslim endoscopy provides less resolution than that of conventional endoscopy and may lead to missed screening of early gastric carcinoma. We evaluated the efficacy of ultraslim endoscopy with flexible spectral imaging color enhancement (FICE) for the diagnosis of early gastric carcinoma. This study included 20 consecutive patients in whom 22 gastric neoplasms were resected by endoscopic submucosal dissection (ESD) between April 2011 and January 2012 in Yamaguchi University Hospital. Prior to ESD, marking dots were made during observation with ultraslim endoscopy with FICE. We evaluated en bloc resection rate and tumor visibility with the FICE system. All tumors were resected with sufficient lateral margin. Only one case had tumor cells in the vertical margin. En bloc resection rate was 95.5 % (21/22 lesions). Ultraslim endoscopy with FICE more clearly visualized tumor margin than did conventional endoscopy. Especially, the effect was remarkable in discolored lesions (100.0 %, 3/3 lesions). Ultraslim endoscopy with FICE improved visibility of gastric neoplasms.