Usefulness of the thread‐traction method in esophageal endoscopic submucosal dissection: Randomized controlled trial

Koike, Yoshiki; Hirasawa, Dai; Fujita, Naotaka; Maeda, Yuki; Ohira, Tetsuya; Harada, Yoshihiro; Suzuki, Kenjiro; Yamagata, Taku; Tanaka, Megumi

doi:10.1111/den.12396

Cited by 80 publications

(61 citation statements)

References 20 publications

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“…Upon pulling of the suture externally, countertraction could be achieved for better exposure of the submucosal plane. A shorter duration of procedure using the "clip traction" method was required compared to conventional ESD (33). Careful hemostasis is needed to avoid reactionary and delayed hemorrhage.…”

Section: Endoscopic Submucosal Dissection (Esd)mentioning

confidence: 99%

Endoscopic diagnosis and management of early squamous cell carcinoma of esophagus

Yip

Chiu

2017

J. Thorac. Dis.

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In recent years, diagnosis of early squamous cell carcinoma (SCC) of the esophagus has been increasingly emphasized. Utilization of image enhanced technology such as narrow band imaging (NBI) and magnification endoscopy allowed detailed examination of the esophageal mucosa. Different patterns of intrapapillary capillary loops (IPCL) have been proven to accurately diagnose and predict the depth of invasion of the tumors. In addition, the application of endoscopic submucosal dissection (ESD) has enabled safe en bloc resection of esophageal lesions. Promising results of ESD have been published and ESD is now the standard of therapy in early SCC of esophagus.

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Section: Endoscopic Submucosal Dissection (Esd)mentioning

confidence: 99%

Endoscopic diagnosis and management of early squamous cell carcinoma of esophagus

Yip

Chiu

2017

J. Thorac. Dis.

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“…This TTSPS made it possible to pull the lesion toward the anal as well as the oral side in gastric cancers [16, 17], and Yamasaki et al [18, 19] and Yamada et al [20] reported methods for colorectal cancers. As a randomized prospective study, Koike et al reported that the thread-traction method was safe and shortened the dissection time and concluded that the thread-traction method was a safer and more useful procedure for esophageal cancers [21–23]. The main conclusions of these studies were that creating good working space for ESD between muscular propria and resected lesion reduced adverse event such as perforation and bleeding.…”

Section: Discussionmentioning

confidence: 99%

Novel effective and repeatedly available ring-thread counter traction for safer colorectal endoscopic submucosal dissection

et al. 2016

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BackgroundAlthough several methods to create an effective counter traction for safer endoscopic submucosal dissection (ESD) have been reported, these methods do not overcome problems regarding delivery and ease of use. This randomized prospective study assessed the usefulness of ring-shaped thread counter traction, which not only allowed the safer colorectal ESD but also the easiest and lower cost counter traction without any special devices.MethodsForty-five patients diagnosed with colorectal lateral spreading tumors over 20 mm were allocated to the conventional ESD group (CE) (n = 22) and the ring-shaped thread counter traction ESD group (RE) (n = 21). The ring-shaped thread was hooked and lifted up to the contralateral mucosa with a hemoclip. The primary outcome was the dissected area per minute during ESD (cm2/min) (UMIN000020160).ResultsThere were significant differences in the dissection time (min), with 130.0 (56.0–240.0) versus 80 (35.0–130.0) min for the CE and RE groups, respectively (P = 0.001). For the dissected areas per minute (cm2/min), there was a significant difference, with 0.125 (0.1–0.18) versus 0.235 (0.16–0.36) min (P = 0.003) for the CE and RE groups, respectively. There were 1 cases of perforation during ESD in the CE compared to 0 for the RE, and this was no significantly different (P = 0.31). The procedure time of producing and setting the ring-shaped thread counter traction was approximately 1.80 (0.80–3.30) min only.ConclusionsThe ring-shaped thread counter traction is simple, effective, lower cost and does not require special devices to obtain repeated counter traction.Electronic supplementary materialThe online version of this article (doi:10.1007/s00464-016-5326-7) contains supplementary material, which is available to authorized users.

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“…Recently, the efficacy of the Thread-Traction method (T-T method) with clips was reported for esophageal ESD, and this procedure has become widespread in Japan 29 30 31. Since the T-T method with clips tenses the submucosal tissue in front of the endoscope, we used this method to transmit the power of the waterjet directly to the edge of dissection and successfully completed the procedure.…”

Section: Discussionmentioning

confidence: 99%

Waterjet submucosal dissection of porcine esophagus with the HybridKnife and ERBEJET 2 system: a pilot study

et al. 2017

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Background and study aims Esophageal endoscopic submucosal dissection (ESD) is technically difficult because of narrow working spaces and ease of perforation due to the lack of serosa. HybridKnife is a recently developed ESD device that is combined with the high pressure waterjet ERBEJET 2 system to lift mucosa. We hypothesized that this waterjet could make submucosal dissection safer and studied this in porcine esophagus. Materials and methods Water pressures of 30 – 70 bar were tested to determine the appropriate pressure for waterjet ESD with HybridKnife (WJ-ESD) in one pig. WJ-ESD safety and completion were compared with those of conventional ESD using DualKnife (C-ESD) as a reference. Each of three virtual esophageal lesions in two pigs were resected alternatively using both methods from the lower to upper esophagus. For WJ-ESD, the submucosa, apart from hard fibrous tissues, was dissected using water pressure alone. Results Using 50 bar of water pressure resulted in the best balance between proper dissection and view-disturbing water backflow. The dissection speeds for the lower, middle, and upper esophagus were 0.2, 0.9, and 0.2 cm2/min in 50 bar WJ-ESD and 1.1, 0.5, and 1.0 cm2/min in C-ESD, respectively. Minor bleeding was frequent in WJ-ESD, but was easily stopped by electrocoagulation with the same needle. No perforation was observed in either procedure. Thermal damage to dissected tissues appeared mild, and the extent of muscle injury was lower for WJ-ESD (4, 6, and 8 %) compared with C-ESD (14, 16, and 7 %). Conclusions WJ-ESD could be completed safely for porcine esophagus with less damage to the muscle layer compared with C-ESD.

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Usefulness of the thread‐traction method in esophageal endoscopic submucosal dissection: Randomized controlled trial

Abstract: The TT method in esophageal ESD was safe and contributed to shortening of dissection time. The TT method is expected to become widespread as a safe and useful procedure.

Cited by 80 publications

References 20 publications

Endoscopic diagnosis and management of early squamous cell carcinoma of esophagus

Endoscopic diagnosis and management of early squamous cell carcinoma of esophagus

Novel effective and repeatedly available ring-thread counter traction for safer colorectal endoscopic submucosal dissection

Waterjet submucosal dissection of porcine esophagus with the HybridKnife and ERBEJET 2 system: a pilot study

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