scholarly journals Effectiveness of Inner Traction Facilitated Endoscopic Submucosal Dissection using Rubber Band and Clips for Colorectal Neoplasms: A Propensity Score-matched Study

2021 ◽  
Author(s):  
Guanyi Liu ◽  
Xinyue Guo ◽  
Yunlong Cai ◽  
Long Rong ◽  
Weidong Nian ◽  
...  
Keyword(s):  
Propensity Score ◽  
Endoscopic Submucosal Dissection ◽  
Propensity Score Matching ◽  
Colorectal Neoplasms ◽  
Rubber Band ◽  
Lateral Spreading ◽  
En Bloc ◽  
Submucosal Dissection ◽  
Colorectal Endoscopic Submucosal Dissection ◽  
Matched Study

Abstract Background Colorectal endoscopic submucosal dissection (ESD) is a technically demanding but effective treatment for superficial neoplasms. We conducted a study to compare the effectiveness and safety of inner traction facilitated ESD using rubber band and clip (RAC-ESD) with conventional ESD.Methods We retrospectively evaluated 622 consecutive patients underwent colorectal ESD between January 2016 and December 2019. To overcome selection bias, we used propensity score matching (1:4) between RAC-ESD and conventional ESD. The frequency of en bloc resections, R0 resections, curative resections, procedure speed and complications were evaluated.Results After propensity score matching, 35 patients were included in RAC-ESD group and 140 were included in conventional ESD group. RAC-ESD resulted in a significant increase in resection speed (0.14 vs. 0.09 cm2/min; P=0.003). There were no significant differences in en bloc, R0 and curative resection rates between two groups. In subgroup analysis, the resection speed of RAC-ESD was significantly higher than conventional ESD when the lesions were equal to or larger than 2cm, macroscopically presenting as lateral spreading tumor, and located in transverse colon to ascending colon.Conclusions RAC-ESD is safe and effective in treating colorectal neoplasms, especially in lesions presenting particular difficulty.

scholarly journals Clinical usefulness of the S-O clip during colorectal endoscopic submucosal dissection in difficult-to-access submucosal layer

2020 ◽  
Vol 08 (03) ◽  
pp. E437-E444 ◽  
Author(s):  
Yuki Okamoto ◽  
Shiro Oka ◽  
Shinji Tanaka ◽  
Katsuaki Inagaki ◽  
Hidenori Tanaka ◽  
...  
Keyword(s):  
Propensity Score ◽  
Endoscopic Submucosal Dissection ◽  
Propensity Score Matching ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
University Hospital ◽  
Submucosal Layer ◽  
En Bloc ◽  
Submucosal Dissection ◽  
Colorectal Endoscopic Submucosal Dissection

Abstract Background and study aims In colorectal endoscopic submucosal dissection (ESD), the S-O clip improves the accessibility to the submucosal layer of the colon. However, its safety and usefulness in difficult colorectal ESDs are unclear. Thus, in this study, we aimed to assess the effectiveness of the S-O clip in colorectal ESD in the difficult-to-access submucosal layer. Patients and methods From January 2016 to December 2016, 189 consecutive cases of colorectal ESD were performed at Hiroshima University Hospital before the S-O clip was introduced. Between January 2017 and June 2018, among 271 consecutive colorectal ESD cases, 41 cases were performed colorectal ESD using the S-O clip. We compared outcomes between the two groups (41 cases with S-O clip [use group] and 189 cases without S-O clip [non-use group]) using propensity score matching. Results Prior to propensity score matching, 41 cases with the S-O clip (use group) and 189 cases without the S-O clip (non-use group) were extracted. The degree of submucosal fibrosis was more severe and the procedure time was longer in the use group than in the non-use group. In the use and non-use groups, en bloc resection (100 % vs. 94.7 %) and complete en bloc resection (100 % vs. 92.6 %) rates were satisfactory. After propensity score matching, 33 cases in each group were extracted. As a result, complete en bloc resection rate was significantly higher in the use group than in the non-use group (100 % vs. 84.9 %). Conclusion The S-O clip is effective and can be used safely in colorectal ESD in the difficult-to-access submucosal layer.

scholarly journals Colorectal endoscopic submucosal dissection using the pocket-creation method with single clip traction: a feasibility study

2021 ◽  
Vol 09 (05) ◽  
pp. E653-E658
Author(s):  
Tatsuma Nomura ◽  
Yoshikazu Hayashi ◽  
Takaaki Morikawa ◽  
Masahiro Okada ◽  
Hisashi Fukuda ◽  
...  
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Major Axis ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Success Rates ◽  
En Bloc ◽  
Submucosal Dissection ◽  
Mucosal Incision ◽  
Axis Length ◽  
Colorectal Endoscopic Submucosal Dissection

Abstract Background and study aims The pocket-creation method (PCM) facilitates dissection of the central part of a tumor. We previously developed the PCM with clip traction (PCM-CT) to facilitate opening the mucosal pocket, which otherwise could become cumbersome. In the present study, we aimed to examine the feasibility of PCM-CT for colorectal endoscopic submucosal dissection (ESD). Patients and methods PCM-CT was performed on 30 patients with early colorectal tumors from October 2019 to April 2020. PCM-CT allows efficient opening of the mucosal pocket by using the PCM to dissect the center of the lesion and then apply traction with a single clip after making a circumferential mucosal incision. Results The median specimen major axis length, ESD time, ESD speed, and en bloc resection rate were 48 mm, 84 minutes, 20 mm2/min, and 100 % (30/30), respectively. The success rates for the traction clip and median single-clip-traction time were 100 % (30/30) and 1.5 minutes, respectively. Conclusions Colorectal ESD using PCM-CT is a simple and promising method.

scholarly journals Clinical Practice of Endoscopic Submucosal Dissection for Early Colorectal Neoplasms by a Colonoscopist with Limited Gastric Experience

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Wen-Hsin Hsu ◽  
Meng-Shun Sun ◽  
Hoi-Wan Lo ◽  
Ching-Yang Tsai ◽  
Yu-Jou Tsai
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Colorectal Neoplasms ◽  
R0 Resection ◽  
En Bloc ◽  
Delayed Bleeding ◽  
Submucosal Dissection ◽  
Limited Experience ◽  
Mean Size ◽  
Delayed Perforation ◽  
The Mean

Objectives. Endoscopic submucosal dissection (ESD) for early colorectal neoplasms is regarded as a difficult technique and should commence after receiving the experiences of ESD in the stomach. The implementation of colorectal ESD in countries where early gastric cancer is uncommon might therefore be difficult. The aim is to delineate the feasibility and the learning curve of colorectal ESD performed by a colonoscopist with limited experience of gastric ESD.Methods. The first fifty cases of colorectal ESD, which were performed by a single colonoscopist between July 2010 and April 2013, were enrolled.Results. The mean of age was 64 (±9.204) years with mean size of neoplasm at 33 (±12.63) mm. The mean of procedure time was 70.5 (±48.9) min. The rates ofen blocresection, R0 resection, and curative resection were 86%, 86%, and 82%, respectively. Three patients had immediate perforation, but no patient developed delayed perforation or delayed bleeding.Conclusion. Our result disclosed that it is feasible for colorectal ESD to be performed by a colonoscopist with little experience of gastric ESD through satisfactory training and adequate case selection.

scholarly journals Endoscopic submucosal dissection using countertraction with clips and rubber band allows safe en bloc resection of recurrent duodenal superficial lesions with intense fibrosis

Endoscopy ◽  
2020 ◽  
Vol 52 (11) ◽  
pp. E398-E399
Author(s):  
Alexandru Lupu ◽  
Julien Faller ◽  
Borathchakra Oung ◽  
Timothée Wallenhorst ◽  
Jérémie Jacques ◽  
...  
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Rubber Band ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
Submucosal Dissection

scholarly journals Traction strategy with clips and rubber band allows complete en bloc endoscopic submucosal dissection of sessile serrated adenoma/polyp invading the site of previous appendectomy

Endoscopy ◽  
2019 ◽  
Vol 51 (07) ◽  
pp. E166-E168 ◽  
Author(s):  
Borathchakra Oung ◽  
Edouard Chabrun ◽  
Clément Subtil ◽  
Elodie Cesbron-Metivier ◽  
Véronique Dumora-Ezponda ◽  
...  
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Rubber Band ◽  
Sessile Serrated Adenoma ◽  
Serrated Adenoma ◽  
En Bloc ◽  
Submucosal Dissection

Short-term outcomes following endoscopic submucosal dissection of large protruding colorectal neoplasms

Endoscopy ◽  
2017 ◽  
Vol 50 (06) ◽  
pp. 606-612 ◽  
Author(s):  
Taku Sakamoto ◽  
Yutaka Saito ◽  
Fumihiko Nakamura ◽  
Seiichiro Abe ◽  
Hiroyuki Takamaru ◽  
...  
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Colorectal Neoplasms ◽  
Clinical Outcomes ◽  
Technical Difficulty ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Procedure Time ◽  
Short Term ◽  
En Bloc ◽  
Submucosal Dissection

Abstract Background Although submucosal dissection is useful for treating laterally spreading colorectal tumors, there is little information regarding the endoscopic treatment of large protruding colorectal neoplasms. Here, we aimed to evaluate the clinical outcomes of endoscopic submucosal dissection for protruding colorectal neoplasms ≥ 20 mm in diameter. Methods In total, 112 consecutive patients undergoing treatment between January 2005 and June 2017 were enrolled retrospectively. The study period was divided into six periods to evaluate any changes in outcomes over time. We reviewed all short-term clinical outcomes, including lesion characteristics, procedure time, and percentages of en bloc resection, curative resection, adverse events, and treatment discontinuation. Results The percentages of en bloc, en bloc R0, and en bloc curative resections were 88 %, 82 %, and 59 %, respectively. Perforation occurred in 11 patients (10 %), and the endoscopic procedure was discontinued in five patients (4 %) because of technical difficulty. For lesions ≥ 40 mm in diameter, the procedure time showed a statistically significant decreasing trend in the latter half of the study period. However, the rate of cure did not improve along with enhancements to the procedure’s technological aspects. Conclusions Although endoscopic submucosal dissection for large protruding lesions has advanced in terms of its technical aspects, its ability to cure large protruding neoplasms has not shown gratifying results.

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