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6 protocols using pcf q260j

1

Endoscopic Submucosal Dissection Techniques

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ESD was performed under conscious sedation by experienced and novice endoscopists in the university hospital setting. Novice endoscopists referred to colonoscopists who had performed fewer than 100 colorectal ESD procedures. A standard colonoscope (PCF-Q260J; Olympus, Tokyo, Japan) or a gastroscope (GIF-Q260J; Olympus, Tokyo, Japan) were used with appropriate distal attachment. The injection solution was a mixture of normal saline and 0.4 % sodium hyaluronate (MucoUp; Johnson & Johnson, New Brunswick, New Jersey, United States) with a small amount of indigo carmine. A FlushKnife (Fujinon-Toshiba ES System Co., Omiya, Japan), DualKnife (KD-650L; Olympus, Tokyo, Japan), and/or SB Knife Jr (Sumitomo Bakelite, Tokyo, Japan) and hemostatic forceps (Coagrasper; Olympus, Tokyo, Japan) were used as appropriate. The ESD procedure was classified as one of two methods: conventional ESD or hybrid ESD. Conventional ESD involved submucosal dissection with a knife, and hybrid ESD involved snaring following circumferential incision and sufficient submucosal dissection
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2

Endoscopic Resection Techniques for NETs

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All patients with NETs were detected by colonoscopy. Preoperative EUS was performed using a UM3R ultrasonic miniprobe (UMP, 20 MHz; Olympus, Tokyo, Japan) to evaluate the tumor size and invasion depth. A single-channel endoscope (GIF-Q260J, PCF-Q260J, Olympus, Tokyo, Japan) was used for the procedures. EMR-C, EMR-CI and ESD were carried out with the use of a transparent cap on the tip of the endoscope. A band ligation device was used for EMR-L. A polypectomy snare (Cook, Winston-Salem, USA) was used to remove the tumor in the m-EMR procedure. A dual knife (Olympus, Tokyo, Japan) and/or an IT (Olympus, Tokyo, Japan) was used for the incision of the mucosa and for submucosal resection. Hemostatic forceps were used to stop and prevent bleeding during the procedure. The VIO200D electrosurgical unit (ERBE, Tubingen, Germany) was used for all the procedures.
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Endoscopic Resection Techniques Optimized

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Endoscopic resection, including ESD and hybrid ESD, was performed using a single-channel endoscope (PCF-Q260J, Olympus, Tokyo, Japan) with a transparent plastic cap on its tip. A VIO200D electrosurgical unit was used (ERBE, Tubingen, Germany). The cutting current was the ENDO CUT mode (effect 3, cut duration 2, and cut interval 2) and the dissection current was the FORCED COAG mode (effect 4 and max Watts 50).
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4

Endoscopic Procedure with Specialized Equipment

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A water jet system‐furnished ultra‐slim endoscope (PCF‐Q260J; Olympus) was used. When scope operability was poor because of paradoxical movement or adhesion, a balloon‐assisted endoscope with a hydrophilic‐coated silicone splinting tube (ST‐CB 1; Olympus) was used (Fig. 2). A transparent disposable attachment (D‐201‐11 804; Olympus) or a short‐type small‐caliber‐tip transparent hood (Fujifilm; Tokyo, Japan) was placed on the endoscopic tip. For all cases, carbon dioxide was used for insufflation. The electrosurgical unit was an ESG‐100 (Olympus). We primarily used a dual knife (KD650Q; Olympus); however, a hook knife (KD‐260R; Olympus) was added in cases with severe fibrosis and a vertical approach.
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5

Endoscopic Submucosal Dissection Technique

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We used an endoscope with a water-jet system (PCF-Q260J; Olympus). When scope operability was poor because of the paradoxical movement or adhesion, a balloon-assisted endoscope with a hydrophilic-coated silicone splinting tube (ST-CB 1; Olympus) was used
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. A short-type small-caliber-tip transparent hood (Fujifilm; Tokyo, Japan) was placed on the endoscopic tip. For all the cases, we used carbon dioxide for insufflation, and the electrosurgical unit was ESG-100 (Olympus). We used a dual knife (KD650Q; Olympus), and ESD was performed under conscious sedation, using intravenous midazolam (1–3 mg), pethidine hydrochloride (35 mg), or both. Submucosal injection of hyaluronic acid solution mixed with a small amount of indigo carmine and 0.1 % epinephrine (1 mL of 0.1 % epinephrine in 9 mL of indigo carmine solution = 1:100,000 injectate) was applied. After injection into the submucosal layer, we alternately performed the partial circumferential incision (“Pulse cut slow" mode [30 W]) and the subsequent submucosal dissection (“Forced coagulation” mode [30 W]). We performed all the ESD procedures as described in the previous study
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6

Colonoscopy Preparation and Sedation

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The bowel preparation method in our hospital was as follows: 10 mL of 0.75% sodium picosulfate hydrate was administered the day before colonoscopy and 2 L of polyethylene glycol electrolyte solution on the morning of the colonoscopy. In all patients, either pethidine (17.5–35 mg) + midazolam (1–5 mg) or funitrazepam (0.2–0.5 mg) was administered for conscious sedation at the beginning of the procedure. Intravenous glucagon or scopolamine was administered to reduce colonic movements. A single-channel endoscope (CF-HQ290ZI, PCF-290ZI, PCF-Q260AZI, PCF-Q260J; Olympus Corporation, Tokyo, Japan) with a transparent attachment at the tip and carbon dioxide insufflation were used.
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