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- Title
Esophageal Endoscopic Submucosal Dissection Assisted by an Overtube with a Traction Forceps: An Animal Study.
- Authors
Ohata, Ken; Fu, Kuangi; Sakai, Eiji; Nonaka, Kouichi; Tashima, Tomoaki; Minato, Yohei; Ohno, Akiko; Ito, Takafumi; Tsuji, Yosuke; Chiba, Hideyuki; Yamawaki, Makoto; Hemmi, Hideyuki; Nakaya, Teruo; Fukushima, Junichi; Matsuhashi, Nobuyuki
- Abstract
Esophageal endoscopic submucosal dissection (ESD) is technically difficult. To make it safer, we developed a novel method using overtube with a traction forceps (OTF) for countertraction during submucosal dissection. We conducted an ex vivo animal study and compared the clinical outcomes between OTF-ESD and conventional method (C-ESD). A total of 32 esophageal ESD procedures were performed by four beginner and expert endoscopists. After circumferential mucosal incision for the target lesion, structured as the isolated pig esophagus 3 cm long, either C-ESD or OTF-ESD was randomly selected for submucosal dissection. All the ESD procedures were completed as en bloc resections, while perforation only occurred in a beginner’s C-ESD procedure. The dissection time for OTF-ESD was significantly shorter than that for C-ESD for both the beginner and expert endoscopists (22.8±8.3 min versus 7.8±4.5 min, P<0.001, and 11.3±4.4 min versus 5.9±2.5 min, P=0.01, resp.). The frequency and volume of the submucosal injections were significantly smaller for OTF-ESD than for C-ESD (1.3±0.6 times versus 2.9±1.5 times, P<0.001, and 5.3±2.8 mL versus 15.6±7.3 mL, P<0.001, resp.). Histologically, muscular injury was more common among the C-ESD procedures (80% versus 13%, P=0.009). Our results indicated that the OTF-ESD technique is useful for the safe and easy completion of esophageal ESD.
- Subjects
ESOPHAGEAL surgery; ENDOSCOPIC surgery; MUCOUS membranes; FORCEPS; INJECTIONS; ANIMAL models in research
- Publication
Gastroenterology Research & Practice, 2016, p1
- ISSN
1687-6121
- Publication type
Article
- DOI
10.1155/2016/3186168