Efficacy of early clip-with-line method for colorectal endoscopic submucosal dissection
- 1 January 2022
- journal article
- research article
- Published by Springer Science and Business Media LLC in Surgical Endoscopy
- Vol. 36 (1), 321-327
- https://doi.org/10.1007/s00464-020-08280-2
Abstract
Background Colorectal endoscopic submucosal dissection (ESD) remains demanding due to technical difficulties and high risk of perforation. Most of the reported traction methods are initiated after creating a mucosal flap, which is time consuming. To obtain a good visualization at the mucosal incision stage, we developed the early clip-with-line (ECL) method. This method was started immediately after injection of sodium hyaluronate solution into the submucosal layer. In this study, we evaluated the efficacy and the safety of the ECL method for colorectal ESD. Methods We retrospectively analyzed all cases of colorectal ESDs (41 cases in total) performed from January 2017 to February 2019 in our institution. From January 2017 to August 2018, 27 of these cases were performed using conventional (non-ECL) ESDs, while from September 2018 onwards, the remaining 14 cases were performed using the ECL method. Retrospective comparison between the ECL group and the non-ECL group was conducted in terms of clinical characteristics, treatment outcomes, and adverse events. Results There were no significant differences in clinical characteristics between two groups. Procedure time (median [range]) was significantly shorter in the ECL group than in the non-ECL group (66 [29-131] min vs 90 [30-410] min; P = 0.03). As for adverse events, no case of perforation occurred in the ECL group, whereas perforation was observed in 7.4% (2/27) cases in the non-ECL group (no significant difference). Conclusion Early clip-with-line method for colorectal endoscopic submucosal dissection reduced procedure time.This publication has 28 references indexed in Scilit:
- Endoscopic mucosal resectionGastrointestinal Endoscopy, 2015
- Quality indicators for colonoscopyGastrointestinal Endoscopy, 2014
- Usefulness of the thread‐traction method in esophageal endoscopic submucosal dissection: Randomized controlled trialDigestive Endoscopy, 2014
- Long-term adenoma recurrence following wide-field endoscopic mucosal resection (WF-EMR) for advanced colonic mucosal neoplasia is infrequent: results and risk factors in 1000 cases from the Australian Colonic EMR (ACE) studyGut, 2014
- Prospective clinical trial of traction device-assisted endoscopic submucosal dissection of large superficial colorectal tumors using the S–O clipSurgical Endoscopy, 2014
- Predictors of incomplete resection and perforation associated with endoscopic submucosal dissection for colorectal tumorsGastrointestinal Endoscopy, 2013
- Colonoscopic Polypectomy and Long-Term Prevention of Colorectal-Cancer DeathsThe New England Journal of Medicine, 2012
- Counter Traction Makes Endoscopic Submucosal Dissection EasierClinical Endoscopy, 2012
- A prospective, multicenter study of 1111 colorectal endoscopic submucosal dissections (with video)Gastrointestinal Endoscopy, 2010
- Pit Pattern in Colorectal Neoplasia: Endoscopic Magnifying ViewEndoscopy, 2001