Nm 200l 0423

A single-channel endoscope (GIF-HQ290, GIF-Q260J; Olympus, Tokyo, Japan) was used during ESD, and a transparent cap was attached to it to facilitate the procedure. A dual knife (KD-650U, KD-650L, Olympus) was used for marking and dissection. A pair of haemostatic forceps (FD-411UR, Olympus) was used to manage the remaining vessels on the ulcer floor. Other equipment included an Endoclip (ROCCD-26-195, Weichuang, Nanjing, China), injection needle (NM-200L-0423, Olympus), high-frequency generator (VIO 200D, ERBE, Tübingen, Germany), 0.2% indigo carmine dye (MICRO-TECH, Nanjing, China), and submucosal injection (a mixed solution of 250 mL normal saline solution + 1 mL indigo carmine + 2 mL norepinephrine). A CO₂ insufflator (UCR, Olympus) was used for insufflation. As the last step, 3 g PHP adhesive (EndoClot Plus Co., Ltd., Suzhou, Jiangsu, China) was applied for post-ESD ulcers.

The instruments used in this study included an electronic endoscope (GIF‐Q260J Gastroscope; Olympus Corporation, Tokyo, Japan), ultrasound endoscope (SU‐9000 Circular Scan Ultrasound Endoscope; Hitachi High‐Technologies Corporation, Tokyo, Japan), argon air knife (VIO‐200 S; ERBE Elektromedizin GmbH, Tübingen, Germany), IT‐Knife2 (KD‐611L; Olympus Corporation, Tokyo, Japan), DualKnife (KD‐650L; Olympus Corporation, Tokyo, Japan), disposable multi‐functional knife (Anrui, Zhejiang, China), disposable injection needle (NM‐200L‐0423; Olympus Corporation, Tokyo, Japan), disposable snare (MTNPFS01‐02423180; Nanwei Medical Technology Co., Ltd., Nanjing, China), hot biopsy forceps (HBF‐16/1800; Nanwei Medical Technology Co., Ltd., Nanjing, China), titanium clip (ROCC‐D‐26‐195; Nanwei Medical Technology Co., Ltd., Nanjing, China), transparent peeling cap (Olympus Corporation, Tokyo, Japan), nylon ligation ring (Figure 1) (Olympus Corporation, Tokyo, Japan), and transparent ligation cap (Figure 2) (Olympus Corporation, Tokyo, Japan). The fluid used for submucosal injection was composed of 250 ml saline, 0.5 mg methylene blue, and 1 mg adrenaline. Intravenous anesthesia was administered with midazolam, meperidine, or propofol.