Efficacy of endoscopic submucosal dissection with dental floss clip traction for gastric epithelial neoplasia: a pilot study (with video)

Yoshida, Masao; Takizawa, Kohei; Ono, Hiroyuki; Igarashi, Kimihiro; Sugimoto, Shinya; Kawata, Noboru; Tanaka, Masaki; Kakushima, Naomi; Ito, Sayo; Imai, Kenichiro; Hotta, Kinichi; Matsubayashi, Hiroyuki

doi:10.1007/s00464-015-4580-4

Cited by 58 publications

(29 citation statements)

References 22 publications

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“…Thus, it does not always provide sufficient traction. 26 To overcome these problems, we modified the "clip-with-line" method [27][28][29][30][31] and developed TAC-ESD, which does not require withdrawal of the colonoscope. However, TAC-ESD has a weak point.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of traction‐assisted colorectal endoscopic submucosal dissection using a clip‐and‐thread technique: A prospective randomized study

Yamasaki

Takeuchi

Uedo

et al. 2018

Digestive Endoscopy

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Section: Discussionmentioning

confidence: 99%

Efficacy of traction‐assisted colorectal endoscopic submucosal dissection using a clip‐and‐thread technique: A prospective randomized study

Yamasaki

Takeuchi

Uedo

et al. 2018

Digestive Endoscopy

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“…Several mucosal traction methods have been employed in esophageal and gastric ESD, which could effectively assist in ESD. In this study, our method also had a good traction effect.…”

Section: Discussionmentioning

confidence: 99%

Snare combined with endoclips in endoscopic submucosal dissection with mucosal traction for gastroesophageal neoplasia

Zhang

Yao

Cai

et al. 2018

J of Gastro and Hepatol

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Background and Aim Mucosal traction as a “second hand” in endoscopic submucosal dissection (ESD) is very helpful for ESD operators. The efficacy of using a snare combined with endoclips to assist in ESD (SC‐ESD) was evaluated whether it could achieve peroral external traction (PET) and peroral internal traction (PIT) and real‐time adjustment of mucosal traction position. This study aimed to preliminarily evaluate its feasibility. Methods A snare was fixed using endoclips to the incised mucosal flap that was intended for dissection. Subsequently, the snare was adjusted to achieve mucosal traction. This study included 54 gastroesophageal neoplasias in 54 consecutive patients who underwent SC‐ESD. The operative and clinical data were retrospectively collected. Results Peroral external tractions were performed for 22 esophageal neoplasias, and PETs and PITs were performed for 32 gastric neoplasias. The median (interquartile range) sizes of lesions were 4.3 (2.5) and 4.2 (2.1) cm, operation times were 73.4 (43.8) and 60.0 (45.2) min, and submucosal dissection times were 27.0 (32.0) and 31.0 (34.5) min in the esophagus and stomach, respectively. Mucosal traction position could be effectively adjusted by fixing the snare to the incised mucosal flap intended for dissection during SC‐ESD. All lesions in the esophagus and stomach were completely resected, with R0 resection rates of 100%. Besides postoperative bleeding in a patient with gastric neoplasia, no intraoperative and postoperative perforations occurred. Conclusions SC‐ESD seems to be feasible for resecting gastroesophageal neoplasia, and two types of mucosal tractions (PET and PIT) could be effectively achieved during SC‐ESD. Further prospective comparative study with a large sample is warranted.

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“…Among the 13 eligible articles of gastric ESD, we identified two RCTs, and 11 retrospective comparative studies. [22][23][24][25][26][27][28][29][30][31][32][33][34] Ten studies compared the efficacy of ESD traction devices, and three other studies investigated the efficacy of traction strategy compared with conventional ESD ( Table 2).…”

Section: Stomachmentioning

confidence: 99%

Efficacy of Current Traction Techniques for Endoscopic Submucosal Dissection

Abe

Ego

et al. 2020

Gut and Liver

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This systematic review aimed to assess the efficacy of the current approach to tissue traction during the endoscopic submucosal dissection (ESD) of superficial esophageal cancer, early gastric cancer, and colorectal neoplasms. We performed a systematic electronic literature search of articles published in PubMed and selected comparative studies to investigate the treatment outcomes of tractionassisted versus conventional ESD. Using the keywords, we retrieved 381 articles, including five eligible articles on the esophagus, 13 on the stomach, and 12 on the colorectum. A total of seven randomized controlled trials and 23 retrospective studies were identified. Clip line traction and submucosal tunneling were effective in reducing the procedural time during esophageal ESD. The efficacy of traction methods in gastric ESD varied in terms of the devices and strategies used depending on the lesion location and degree of submucosal fibrosis. Several prospective and retrospective studies utilized traction devices without the need to reinsert the colonoscope. When pocket creation is included, the traction devices and methods effectively shorten the procedural time during colorectal ESD. Conclusions: Although the efficacy is dependent on the organ and tumor locations, several traction techniques have been demonstrated to be efficacious in facilitating ESD by maintaining satisfactory traction during dissection. (Gut Liver,

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Efficacy of endoscopic submucosal dissection with dental floss clip traction for gastric epithelial neoplasia: a pilot study (with video)

Abstract: DFC effectively reduced ESD procedure time without increasing adverse events. DFC is helpful for rapid, safe ESD.

Cited by 58 publications

References 22 publications

Efficacy of traction‐assisted colorectal endoscopic submucosal dissection using a clip‐and‐thread technique: A prospective randomized study

Efficacy of traction‐assisted colorectal endoscopic submucosal dissection using a clip‐and‐thread technique: A prospective randomized study

Snare combined with endoclips in endoscopic submucosal dissection with mucosal traction for gastroesophageal neoplasia

Efficacy of Current Traction Techniques for Endoscopic Submucosal Dissection

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