Endoscopic submucosal dissection of appendiceal lesions by using a novel adjustable traction device: A-TRACT-2

Masgnaux, Louis-Jean; Grimaldi, Jean; Rostain, Florian; Bienvenue, Isaure; Jacques, Jérémie; Rivory, Jérôme; Pioche, Mathieu

doi:10.1016/j.vgie.2022.09.008

Cited by 5 publications

(6 citation statements)

References 4 publications

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“…Although the A-TRACT was previously described in colonic lesions [7,8], to our knowledge, this is the first case report of the use of an adjustable traction device for ESD of a gastric lesion. This technique is a promising and innovative addition to the therapeutic armamentarium for the treatment of EGC.…”

mentioning

confidence: 89%

Endoscopic Submucosal Dissection of a Large Gastric Lesion Using a Novel Adjustable Traction Device: A-TRACT 4

Morais,

Figueiredo,

Masgnaux

et al. 2023

GE Port J Gastroenterol

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mentioning

confidence: 89%

Endoscopic Submucosal Dissection of a Large Gastric Lesion Using a Novel Adjustable Traction Device: A-TRACT 4

Morais,

Figueiredo,

Masgnaux

et al. 2023

GE Port J Gastroenterol

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“…To mitigate the risk of specimen damage, an initial incision in retroflexion of the anal lip in the terminal ileum can be attempted particularly after traction placement on the valvula to open it largely. In addition, the traction strategy can be used to open the valvula itself facilitates the dissection by improving the exposure of the margin and directly on the edge of the lesion to facilitate the resection as previously described in different locations [5,6,11]. The treatment of circumferential lesions is also at higher risk of lateral margins coagulation on the ileal side because the diameter of the ileum is very thin.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…Conversely, endoscopic submucosal dissection (ESD) allows for en bloc resection of large lesions in approximately 90% of cases [2,3]. ESD is feasible in the entire colon tract, even in intricate locations such as peridiverticular lesions, appendiceal sites, or the ICV [4,5,6,7]. The feasibility of ESD in the ICV location has been demonstrated in Eastern countries, with en bloc resection and R0 resection rates of 97% and 89%, respectively [8].…”

Section: Introductionmentioning

confidence: 99%

Traction-assisted endoscopic submucosal dissection to resect ileo-cecal valve neoplasia: a French retrospective multicenter case series

Yzet,

Wallenhorst,

Jacques

et al. 2024

Endoscopy

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Introduction: The ileocecal valve (ICV) is considered to be one of the most difficult locations for endoscopic submucosal dissection (ESD). The objective of this study was to evaluate the efficacy and safety of traction-assisted ESD in this situation. Methods: All patients who underwent traction assisted ESD for an ICV lesion were identified from a prospective ESD database in three centers. The results were evaluated in terms of en bloc, R0 rate. Factors associated with R0 failure were explored. Results: In total, 106 patients with an ileocecal lesion were included. The median diameter of the lesions was 50 mm (IQR 38-60) and 58.4% (62/106) invaded the terminal ileum. The en-bloc and R0 resection rates were 94.8% and 76.4%, respectively. Factors associated with R0 failure were lesions covering more than 75% of the ICV (OR, 0.21 [0.06, 0.76] p = 0.018), anal lip involvement (OR 0.36 [0.13, 0.99], p= 0.037), and more than two sites of the ICV (OR 0.28 [0.08, 1.01] p = 0.030). Conclusion: Traction-assisted ESD to treat ICV lesions is a safe and feasible option. Large lesions and anal lip involvement appear to be factors predictive of difficulty.

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“…A handmade multipolar traction device with a tightenable loop was used to increase the force of traction on multipolar points. Several descriptions of the use of this device in clinical cases have been published [5][6][7][8][9][10], and we report here the first series, consisting of the initial 54 consecutive procedures.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic submucosal dissection assisted by adaptive traction: results of the first 54 procedures

Masgnaux,

Grimaldi,

Rivory

et al. 2023

Endoscopy

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Background: Good submucosal exposure is key to successful endoscopic submucosal dissection (ESD) and can be achieved with different traction devices. Nevertheless, these devices have a fixed traction force that tends to decrease as the dissection progresses. By contrast, the ATRACT adaptive traction device increases traction during the procedure. Methods: In this retrospective analysis of data (from a French database) collected prospectively, we analysed ESD procedures performed with the ATRACT device between April 2022 and October 2022. The device was used consecutively whenever possible. We collected characteristics of lesions, procedural data, histological outcomes, as well as clinical consequences for the patient. Results: A total of 54 resections performed in 52 patients by two experienced operators (46 procedures) and six novices (8 procedures) were analysed. The ATRACT devices used were the ATRACT2 (21), the ATRACT2+2 (30), and the ATRACT4 (3). Four adverse events were observed: one perforation (1.9%) closed endoscopically and three delayed bleeding events (3.8%). The R0 rate was 96%, resulting in curative resection in 90% of cases. Conclusion: ESD using the ATRACT device is safe and effective for the colon and rectum but can also be used to assist with procedures in the upper gastrointestinal tract. It may be particularly useful in difficult locations.

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Endoscopic submucosal dissection of appendiceal lesions by using a novel adjustable traction device: A-TRACT-2

Cited by 5 publications

References 4 publications

Endoscopic Submucosal Dissection of a Large Gastric Lesion Using a Novel Adjustable Traction Device: A-TRACT 4

Endoscopic Submucosal Dissection of a Large Gastric Lesion Using a Novel Adjustable Traction Device: A-TRACT 4

Traction-assisted endoscopic submucosal dissection to resect ileo-cecal valve neoplasia: a French retrospective multicenter case series

Endoscopic submucosal dissection assisted by adaptive traction: results of the first 54 procedures

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