Endoscopic submucosal dissection with a combination of small-caliber-tip transparent hood and flex knife is a safe and effective treatment for superficial esophageal neoplasias

Abstract

ESD with a combination of small-caliber-tip transparent hood and flex knife is a safe endoscopic treatment for superficial esophageal neoplasias and enables large en bloc resection.

Endoscopic submucosal dissection with a combination of small-caliber-tip transparent hood and flex knife for superficial esophageal neoplasia. Is it safe for elderly patients?

“…Recently, ESD has been applied to esophageal neoplasias because it provides a higher en bloc resection rate and is less invasive than surgical resection [4][5][6][7][8][9].…”

“…After additional injection was made to lift the lesion, the smallcaliber-tip transparent hood attached to the endoscope tip, was inserted into the thickened submucosal layer to maintain a satisfactory view and make this layer more stretched so that the submucosal layer could be dissected safely (Figs. 7,8,9). During dissecting of the submucosal layer, the flex knife was set to approximately 1 mm in length and the electrosurgical generator output was set at 20 W in swift coagulation mode, effect 3.…”

“…ESD is a novel technique to dissect the submucosal layer directly using specialized devices [2][3][4][5][6][7][8][9]. ESD procedures for superficial esophageal neoplasias were performed with a single-accessory channel endoscope (GIF-Q260 J; Olympus Optical Co, Ltd, Tokyo, Japan).…”

Endoscopic submucosal dissection with a combination of small-caliber-tip transparent hood and flex knife for large superficial colorectal neoplasias including ileocecal lesions

“…In this study, we applied a combination of flex knife and small-caliber-tip transparent hood to colorectal ESD such as esophageal ESD [29]. The flex knife has special features [2].…”

Repeat endoscopic submucosal dissection for recurrent gastric cancers after endoscopic submucosal dissection

“…Marking dots for the incision were made 3-5 mm outside of lesion margins with a flex knife [19][20][21] (Flex Knife TM , KD-630L; Olympus Medical Systems, Tokyo, Japan) ( Figure 1A and B). A solution of 0.4%-0.5% sodium hyaluronate was injected into the submucosal layer beneath the lesion, and circumferential incisions were made around the marking dots with a flex knife.…”