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Early gastric malignancies and premalignant neoplasia have been treated successfully with endoscopic mucosal resection or dissection, but complete removal requires accurate identification of the margins. In East Asia, where early gastric malignancy is more commonly detected, chromoendoscopy with indigo carmine dye has been used to define lesion margins prior to endoscopic therapy.
Investigators in Japan compared the efficacy of indigo carmine dye, acetic acid, or a combination of both to accurately identify lesions prior to endoscopic mucosal dissection. Forty-seven consecutive patients with 53 malignant or premalignant gastric lesions were studied. Lesions were first examined using standard endoscopy and then sprayed with indigo carmine dye…