A Novel Snare Traction-Assisted Method During Endoscopic Resection for Upper Gastrointestinal Submucosal Tumors

Hu, Jiancong; Liu, Wei; Lin, Dezheng; Su, Mingli; Lan, Ping

doi:10.1089/lap.2020.0462

Cited by 6 publications

(6 citation statements)

References 29 publications

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“…Another critical point is the latent risk of tearing the tumor's capsule or mucosa when employing a snare. While neither preceding studies 6,17 nor our own investigation have documented such occurrences, the possibility warrants a rigorous approach. More detailed microscopic pathological assessments, including the tumor areas being grasped, and ongoing follow‐up examinations are vital, given that any damage to the capsule might precipitate the persistence or recurrence of the tumor.…”

Section: Discussionmentioning

confidence: 74%

“…Assisting EFTR with single snare seems a good method: Lu 6 found that, compared with conventional EFTR, the snare‐assisted traction and clip line traction both significantly reduced mean operative time. In another case series, 17 snare traction method successfully facilitated four cases EFTR for gastric and duodenal SMTs. In above two studies, snare was tightened to the tip of the gastroscope, then the snare was released to trap the lesion under endoscopic views.…”

Section: Discussionmentioning

confidence: 93%

“…To successfully grasp the lesion, endoscopists need receiving specific training 6 or the help of a biopsy forceps inserted through the forceps channel. 17 No fixed point of force is the main reason for difficulty in trapping lesion by snare, causing instability when pushing and tightening the snare (Fig. 4b).…”

Section: Discussionmentioning

confidence: 99%

“…In above two studies, snare was tightened to the tip of the gastroscope, then the snare was released to trap the lesion under endoscopic views. To successfully grasp the lesion, endoscopists need receiving specific training 6 or the help of a biopsy forceps inserted through the forceps channel 17 …”

Section: Discussionmentioning

confidence: 99%

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Facilitating endoscopic full‐thickness resection for gastric submucosal tumors with a novel snare traction method (with video)

Gu,

Wang,

Ouyang

et al. 2023

J of Gastro and Hepatol

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Background and AimEndoscopic full‐thickness resection (EFTR) is a promising technique in treating gastric submucosal tumors originating from the muscularis propria (SMT‐MPs). However, it is challenging without counter‐traction.MethodsA snare was inserted through the forceps channel to grasp the part of the tumor or the mucosa connected to the tumor. The outer sheath and inner wire of snare in vitro were fixed by a pair of hemostatic forceps. The handle of snare was cut off, and the endoscope was pulled out without affecting the traction state of snare. Snare‐assisted EFTR (EFTR‐S) was then performed with counter‐traction. One hundred and four patients with gastric SMT‐MPs who received the procedure of EFTR with or without snare traction method were retrospectively analyzed using univariate and multiple regressions, and covariates were adjusted in the multiple analysis.ResultsCompared with EFTR group (n = 36), EFTR‐S group (n = 68) showed a higher operative success rate (95.6% vs 72.2%, P = 0.001), a lower incidence of intraoperative hemorrhage (4.4% vs 16.7%, P = 0.038) and shorter operative time among operative successes (53.6 ± 16.6 min vs 67.7 ± 33.4 min, P < 0.001). Univariate logistic analysis showed that snare traction represented a significant factor, which could improve operative successful rate (odds ratio, 8.3; 95% confidence interval, 2.1 to 32.7; P = 0.002). Postoperative outcomes and adverse events among operative successes were similar between the two groups.ConclusionsThis novel snare traction method may provide an effective counter‐traction and reduce the difficulty of EFTR for gastric SMT‐MPs.

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Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Facilitating endoscopic full‐thickness resection for gastric submucosal tumors with a novel snare traction method (with video)

Gu,

Wang,

Ouyang

et al. 2023

J of Gastro and Hepatol

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“…Controversies remain concerning the specific indications for endoscopic resection for small gastric tumors originating from muscularis propria. Based on current experience, patients with intraluminal submucosal tumors without ulceration, and maximal tumor diameter of 2 cm measured by endoscopic ultrasonography (EUS) or computed tomography (CT), and no evidence of lymph node involvement or distant metastasis are candidates for snare-assisted endoscopic resection ( 16 , 17 ). Differentiation between potentially malignant gastrointestinal stromal tumors and other benign or non-neoplastic lesions is extremely difficult using image methods, especially for small lesions.…”

Section: Snare Assisted Endoscopic Resection- Indications and Limitat...mentioning

confidence: 99%

Advances in endoscopic resection techniques of small gastric tumors originating from the muscularis propria

et al. 2022

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Gastrointestinal stromal tumors are common gastrointestinal tumors typically originating from the muscularis propria layer of the stomach. Small gastric stromal tumors are usually detected incidentally during routine endoscopic examination. Although they may have malignant potentially, controversies remain regarding the need for endoscopic resection of small gastric stromal tumors originating from the muscularis propria. According to the guidelines of the European Society of Medical Oncology, all gastrointestinal stromal tumors >2 cm in size should be resected with endoscopic surveillance recommended for tumors <2 cm. Endoscopic resection including endoscopic mucosal dissection (EMD), endoscopic submucosal dissection (ESD), submucosal tunneling endoscopic resection and snare assisted endoscopic resection. However, EMD and ESD procedures may be accompanied with serious complications including perforation, bleeding, and abdominal infection. Snare-assisted endoscopic resection is an alternative approach and has the advantages of a shorter procedure time and a low rate of perforation or bleeding. This study summarizes the safety and feasibility of a novel snare-assisted endoscopic resection technique and highlights the pros and cons of the different endoscopic approaches currently used for subepithelia small gastric tumors.

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Efficacy and safety of esophageal submucosal tumors treated with internal traction method-assisted submucosal tunneling endoscopic resection: a single-center, single-blind, randomized controlled study

Wang²,

Mei

2022

Surg Endosc

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A Novel Snare Traction-Assisted Method During Endoscopic Resection for Upper Gastrointestinal Submucosal Tumors

Cited by 6 publications

References 29 publications

Facilitating endoscopic full‐thickness resection for gastric submucosal tumors with a novel snare traction method (with video)

Facilitating endoscopic full‐thickness resection for gastric submucosal tumors with a novel snare traction method (with video)

Advances in endoscopic resection techniques of small gastric tumors originating from the muscularis propria

Efficacy and safety of esophageal submucosal tumors treated with internal traction method-assisted submucosal tunneling endoscopic resection: a single-center, single-blind, randomized controlled study

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