Subscribe to RSS
Download PDF
DOI: 10.1055/a-1971-1508
Efficacy of the specialized scissor-type knife for gastric endoscopic submucosal dissection: a propensity score matched retrospective study
Abstract
Background and study aims Prevention of bleeding and perforation during gastric endoscopic submucosal dissection (ESD) is important. Scissor-type knives can accurately grasp and incise the targeted tissue using electrosurgical currents, thereby eliminating unexpected incisions. The SB Knife GX, a scissor-type knife specialized for gastric ESD, was released in June 2016 in Japan. The aim of the present study was to evaluate the efficacy and safety of gastric ESD using the SB Knife GX.
Patients and methods A total of 716 patients who underwent gastric ESD at Hiroshima University Hospital between July 2016 and December 2020 were retrospectively reviewed. From these, 671 patients underwent ESD using the IT Knife 2 (IT-2 group), while 45 underwent ESD using an SB Knife GX (SB-GX group). After propensity score matching, the procedure time, specimen size, en bloc and complete resection rates, and intraoperative bleeding, delayed bleeding, and perforation rates were evaluated.
Results No significant differences were observed in mean procedure time (SB-GX group: 115 ± 165 min; IT-2 group: 95 ± 61 min; P = 0.82) and en bloc and complete resection rates between the two groups. Intraoperative bleeding rates were significantly lower in the SB-GX group than in the IT-2 group (18 % vs. 40 %; P = 0.01), and there were no differences in delayed bleeding (4 % vs. 4 %) or perforation (0 % vs. 4 %) between the two groups.
Conclusions The SB Knife GX was proven to be useful for control of intraoperative bleeding during gastric ESD, although the procedure time tended to be longer.
Publication History
Received: 08 June 2022
Accepted after revision: 25 October 2022
Accepted Manuscript online:
02 November 2022
Article published online:
04 April 2023
© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
References
- 1 Oka S, Tanaka S, Kaneko I. et al. Advantage of endoscopic submucosal dissection compared with EMR for early gastric cancer. Gastrointest Endosc 2006; 64: 877-883
- 2 Oka S, Tanaka S, Kaneko I. et al. Endoscopic submucosal dissection for residual/local recurrence of early gastric cancer after endoscopic mucosal resection. Endoscopy 2006; 38: 996-1000
- 3 Higashimaya M, Oka S, Tanaka S. et al. Outcome of endoscopic submucosal dissection for gastric neoplasm in relationship to endoscopic classification of submucosal fibrosis. Gastric Cancer 2013; 16: 404-410
- 4 Ono H, Kondo H, Gotoda T. et al. Endoscopic mucosal resection for treatment of early gastric cancer. Gut 2001; 48: 225-229
- 5 Gotoda T, Yamamoto H, Soetikno RM. Endoscopic submucosal dissection of early gastric cancer. J Gastroenterol 2006; 41: 929-942
- 6 Oka S, Tanaka S, Higashiyama M. et al. Clinical validity of the expanded criteria for endoscopic resection of undifferentiated-type early gastric cancer based on long-term outcomes. Surg Endosc 2014; 28: 639-647
- 7 Ono H, Hasuike N, Inui T. et al. Usefulness of a novel electrosurgical knife, the insulation-tipped diathermic knife-2, for endoscopic submucosal dissection of early gastric cancer. Gastric Cancer 2008; 11: 47-52
- 8 Toyonaga T, Nishino E, Hirooka T. et al. Use of short needle knife for esophageal endoscopic submucosal dissection. Dig Endosc 2005; 17: 246-252
- 9 Yahagi N, Uraoka T, Ida Y. et al. Endoscopic submucosal dissection using the Flex and the Dual knives. Tech Gastrointest Endosc 2011; 13: 74-78
- 10 Akahoshi K, Akahane H, Murata A. et al. Endoscopic submucosal dissection using a novel grasping type scissors forceps. Endoscopy 2007; 39: 1103-1105
- 11 Honma K, Kobayashi M, Watanabe H. et al. Endoscopic submucosal dissection for colorectal neoplasia. Dig Endosc 2010; 22: 307-311
- 12 Oyama T, Tomori A, Hotta K. et al. Endoscopic submucosal dissection of early esophageal cancer. Clin Gastroenterol Hepatol 2005; 3: S67-S70
- 13 Esaki M, Suzuki S, Hayashi Y. et al. Splashi M-knife versus flush knife BT in the technical outcomes of endoscopic submucosal dissection for early gastric cancer: a propensity score matching analysis. BMC Gastroenterol 2018; 18: 35
- 14 Ohkuwa M, Hosokawa K, Boku N. et al. New endoscopic treatment for intramucosal gastric tumors using an insulated-tip diathermic knife. Endoscopy 2001; 33: 221-226
- 15 Bhatt A, Abe S, Kumaravel A. et al. Indications and techniques for endoscopic submucosal dissection. Am J Gastroenterol 2015; 110: 784-791
- 16 Kitagawa Y, Suzuki T, Hara T. et al. Safety and efficacy of endoscopic submucosal dissection using IT knife nano with clip traction method for early esophageal squamous cell carcinoma. Surg Endosc 2018; 32: 450-455
- 17 Sumida Y, Kuwai T, Sauid Ishaq. Endoscopic submucosal dissection of early gastric neoplasms in the fornix using the newly developed scissor-type SB knife GX. Dig Endosc 2018; 30: 132
- 18 Kanazawa N, Uchiyama S, Sekino Y. et al. Efficacy of the Stag-Beele knife GX for endoscopic submucosal dissection in patient with gastric superficial neoplasms. Prog Dig Endosc 2018; 92: 54-58
- 19 Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2014 (ver. 4). Gastric Cancer 2017; 20: 1-19
- 20 Ono H, Yao K, Fujishiro M. et al. Guidelines for endoscopic submucosal dissection and endoscopic mucosal resection for early gastric cancer. Dig Endosc 2016; 28: 3-15
- 21 Yamamoto S, Uedo N, Ishihara R. et al. Endoscopic submucosal dissection for early gastric cancer performed by supervised residents: assessment of feasibility and learning curve. Endoscopy 2009; 41: 923-928
- 22 Choi IJ, Kim CG, Chang HJ. et al. The learning curve for EMR with circumferential mucosal incision in treating intramucosal gastric neoplasm. Gastrointest Endosc 2005; 62: 860-865
- 23 Gotoda T, Friedland S, Hamanaka H. et al. A learning curve for advanced endoscopic resection. Gastrointest Endosc 2005; 62: 866-867
- 24 Tsuji Y, Ohata K, Sekiguchi M. et al. An effective training system for endoscopic submucosal dissection of gastric neoplasm. Endoscopy 2011; 43: 1033-1038
- 25 Sanomura Y, Oka S, Tanaka S. et al. Clinical validity of endoscopic submucosal dissection for submucosal invasive gastric cancer: a single-center study. Gastric Cancer 2012; 15: 97-105
- 26 Sanomura Y, Oka S, Tanaka S. et al. Predicting the absence of lymph node metastasis of submucosal invasive gastric cancer: expansion of the criteria for curative endoscopic resection. Scand J Gastroenterol 2010; 45: 1480-1487
- 27 Higashiyama M, Oka S, Tanaka S. et al. Risk factors for bleeding after endoscopic submucosal dissection of gastric epithelial neoplasm. Dig Endosc 2011; 23: 290-295
- 28 Higashimaya M, Oka S, Tanaka S. et al. Endoscopic submucosal dissection for residual early gastric cancer after endoscopic submucosal dissection. Gastrointest Endosc 2013; 77: 298-302
- 29 Yoshida N, Dohi O, Inoue K. et al. Efficacy of scissor-type knives for endoscopic mucosal dissection of superficial gastrointestinal neoplasms. Dig Endosc 2020; 32: 4-15
- 30 Nagai K, Uedo N, Yamashina T. et al. A comparative study of grasping-type scissors forceps and insulated-tip knife for endoscopic submucosal dissection of early gastric cancer: a randomized controlled trial. Endosc Int Open 2016; 4: E654-E660
- 31 Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer 2011; 14: 101-112
- 32
Tajiri H,
Kitano S.
Complications associated with endoscopic mucosal resection: definition of bleeding
that can be viewed as accidental. Dig Endosc 2004; 16: S134-S136
MissingFormLabel
- 33 Oka S, Tanaka S, Kanao H. et al. Usefulness and safety of SB knife Jr in endoscopic submucosal dissection for colorectal tumors. Dig Endosc 2012; 24: 90-95
- 34 Dohi O, Yoshida N, Terasaki K. et al. Efficacy of clutch cutter for standardizing endoscopic submucosal dissection for early gastric cancer: a propensity score-matched analysis. Digestion 2019; 100: 201-209
- 35 Fujinami H, Hosokawa A, Ogawa K. et al. Endoscopic submucosal dissection for superficial esophageal neoplasms using the stag beetle knife. Dis Esophagus 2014; 27: 50-54
- 36 Yamashina T, Takeuchi Y, Nagai K. et al. Scissor-type knife significantly improves self-completion rate of colorectal endoscopic submucosal dissection: Single-center prospective randomized trial. Dig Endosc 2017; 29: 322-329
- 37 Yamamoto S, Uedo N, Ishihara R. et al. Endoscopic submucosal dissection for early gastric cancer performed by supervised residents: assessment of feasibility and learning curve. Endoscopy 2009; 41: 923-928
- 38
Matsumoto A,
Tanaka S,
Oba S.
et al. Outcome of endoscopic submucosal dissection for colorectal tumors accompanied
by fibrosis. Scand J Gastroenterol 2010; 45: 1329-1337
MissingFormLabel
- 39 Horikawa Y, Fushimi S, Sato S. Hemorrhage control during gastric endoscopic submucosal dissection: Techniques using uncovered knives. JGH Open 2020; 4: 4-10
- 40 Akahoshi K, Honda K, Motomura Y. et al. Endoscopic submucosal dissection using a grasping type scissors forceps for early gastric cancers and adenomas. Dig Endosc 2011; 23: 24-29
- 41 Akahoshi K, Akahane H, Motomura Y. et al. A new approach: endoscopic submucosal dissection using the Clutch Cutter for early stage digestive tract tumors. Digestion 2012; 85: 80-84
- 42 Nishiyama N, Kobara H, Fujihara S. et al. Endoscopic submucosal dissection for neoplasia of the greater curvature of the upper and middle stomach: J-shaped superficial cutting and splashed dissection. J Gastrointest Liver Dis 2019; 28: 397-404
- 43 Toyonaga T, Nishino E, Hirooka T. et al. Intraoperative bleeding in endoscopic submucosal dissection in the stomach and strategy for prevention and treatment. Dig Endosc 2006; 18: 123-127
- 44 Yoshioka T, Nishida T, Tsujii M. et al. Renal dysfunction is an independent risk factor for bleeding after gastric ESD. Endosc Int Open 2015; 3: E39-E45
- 45 Numata N, Oka S, Tanaka S. et al. Clinical outcomes of endoscopic submucosal dissection for early gastric cancer in patients with chronic kidney disease. J Gastroenterol Hepatol 2013; 28: 1632-1637
- 46 Akahoshi K, Motomura Y, Kubokawa M. et al. Endoscopic submucosal dissection for early gastric cancer using the Clutch Cutter: a large single-center experience. Endosc Int Open 2015; 3: E432-E438
- 47 Hayashi Y, Esaki M, Suzuki S. et al. Clutch cutter knife efficacy in endoscopic submucosal dissection for early gastric neoplasms. World J Gastrointest Oncol 2018; 10: 487-495