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DOI: 10.1055/a-2011-1836
First clinical experience with esophageal ESD using a novel adjustable traction device
Abstract
Background and study aims In esophageal endoscopic submucosal dissection (ESD), the effectiveness of traction including clip-thread method has been reported, but it is difficult to adjust the direction of traction. Therefore, we developed a dedicated over-tube type traction device (ENDOTORNADO) that has a working channel and allows traction from any directions by rotating itself. We investigated the clinical feasibility and potential usefulness of this new device in esophageal ESD.
Patients and methods This was a single-center, retrospective study. Six cases of esophageal ESD with ENDOTORNADO from January to March 2022 (tESD group) were compared with 23 cases of conventional esophageal ESD performed by the same operator from January 2019 to December 2021 (cESD group) in terms of clinical treatment outcomes.
Results In all cases, en bloc resection was achieved without intraoperative perforation. The total procedure speed was significantly increased in tESD group (23 vs. 30 mm2/min, P = 0.046). In particular, the submucosal dissection time was significantly reduced to about one-quarter in tESD group (11 vs. 42 min, P = 0.004).
Conclusions ENDOTORNADO creates the adjustable traction from any directions and may have the clinical feasibility. It would be an option for human esophageal ESD.
Publikationsverlauf
Eingereicht: 18. Dezember 2022
Angenommen nach Revision: 29. Dezember 2022
Accepted Manuscript online:
11. Januar 2023
Artikel online veröffentlicht:
09. Mai 2023
© 2023. 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
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References
- 1 Tsujii Y, Nishida T, Nishiyama O. et al. Clinical outcomes of endoscopic submucosal dissection for superficial esophageal neoplasms: a multicenter retrospective cohort study. Endoscopy 2015; 47: 775-783
- 2 Kato M, Nakajima K, Yamada T. et al. Esophageal submucosal dissection under steady pressure automatically controlled endoscopy (SPACE): a clinical feasibility study. Endoscopy 2014; 46: 680-684
- 3 Noguchi M, Yano T, Kato T. et al. Risk factors for intraoperative perforation during endoscopic submucosal dissection of superficial esophageal squamous cell carcinoma. World J Gastroenterol 2017; 23: 478-485
- 4 Yoshida M, Takizawa K, Nonaka S. et al. Conventional versus traction-assisted endoscopic submucosal dissection for large esophageal cancers: a multicenter, randomized controlled trial (with video). Gastrointest Endosc 2020; 91: 55-65.e52
- 5 Uppal DS, Wang AY. Traction-assisted endoscopic submucosal dissection in the esophagus: Should we all be flossing?. Gastrointest Endosc 2020; 91: 66-69
- 6 Ge PS, Thompson CC, Jirapinyo P. et al. Suture pulley countertraction method reduces procedure time and technical demand of endoscopic submucosal dissection among novice endoscopists learning endoscopic submucosal dissection: a prospective randomized ex vivo study. Gastrointest Endosc 2019; 89: 177-184
- 7 Ota M, Nakamura T, Hayashi K. et al. Usefulness of clip traction in the early phase of esophageal endoscopic submucosal dissection. Dig Endosc 2012; 24: 315-318
- 8 Hirota M, Kato M, Yamasaki M. et al. A novel endoscopic submucosal dissection technique with robust and adjustable tissue traction. Endoscopy 2014; 46: 499-502