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Recent Development of Techniques and Devices in Colorectal Endoscopic Submucosal Dissection
Hiroya Mizutani,Satoshi Ono,Daisuke Ohki,Chihiro Takeuchi,Seiichi Yakabi,Yosuke Kataoka,Itaru Saito,Yoshiki Sakaguchi,Chihiro Minatsuki,Yosuke Tsuji,Keiko Niimi,Shinya Kodashima,Nobutake Yamamichi,Mit 대한소화기내시경학회 2017 Clinical Endoscopy Vol.50 No.6
Colorectal endoscopic submucosal dissection (ESD) is now a well-established endoscopic treatment for early-stage colorectal neoplasms, especially in Asian countries, including Japan. Despite the spread of colorectal ESD, there are still situations in which achieving successful submucosal dissection is difficult. Various novel techniques and devices have been developed to overcome these difficulties, and past reports have shown that some of these strategies can be applied to colorectal ESD. We review several recent developments in the field. The techniques reviewed include the pocket creation method and traction methods and the devices reviewed include the overtube with balloon and electrosurgical knives with water-jet function. These improved techniques and devices can facilitate safer, more reliable ESDs and expand its applicability and acceptability all over the world.
Daisuke Ide,Tomohiko Richard Ohya,Mitsuaki Ishioka,Yuri Enomoto,Eisuke Nakao,Yuki Mitsuyoshi,Junki Tokura,Keigo Suzuki,Seiichi Yakabi,Chihiro Yasue,Akiko Chino,Masahiro Igarashi,Akio Nakashima,Masayuk 대한소화기내시경학회 2022 Clinical Endoscopy Vol.55 No.5
Background/Aims: Endoscopic submucosal dissection (ESD) for residual or recurrent colorectal lesions after incomplete resection is challenging because of severe fibrosis. This study aimed to compare the efficacy of the pocket-creation method (PCM) with a traction device (TD) with that of conventional ESD for residual or recurrent colorectal lesions. Methods: We retrospectively studied 72 patients with residual or recurrent colorectal lesions resected using ESD. Overall, 31 and 41 le- sions were resected using PCM with TD and conventional ESD methods, respectively. We compared patient background and treatment outcomes between the PCM with TD and conventional ESD groups, respectively. The primary endpoints were en bloc resection and R0 resection rates. The secondary endpoints were the dissection speed and incidence of adverse events. Results: En bloc resection was feasible in all cases with PCM with TD, but failed in 22% of cases of conventional ESD. The R0 resection rates for PCM with TD and conventional ESD were 97% and 66%, respectively. Dissection was significantly faster in the PCM with TD group (13.0 vs. 7.9 mm2/min). Perforation and postoperative bleeding were observed in one patient in each group. Conclusions: PCM with TD is an effective method for treating residual or recurrent colorectal lesions after incomplete resection.