Abstract
It is difficult to treat early gastric cancer in areas near the pyloric ring (p-ring) in the antrum, the p-ring, and the region from the p-ring to inside the duodenal bulb by ESD. Because we must set a resection line at a safe distance from the anal side of the tumor, and the endoscope must be reversed inside the duodenal bulb. It is limited by scope flexibility for conventional endoscopy. Even it is possible, complications, perforations and bleeding caused by excessive force by difficulty with scope control due to limited range of motion may be occurred. Here we used a transnasal endoscopy (TN-E) narrower than conventional endoscopes.
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