Gel immersion endoscopy-facilitated endoscopic mucosal resection of a superficial nonampullary duodenal epithelial tumor: a novel approach

Miyakawa, Akihiro; Kuwai, Toshio; Miyauchi, Teruaki; Shimura, H; Sakai, Kenji

doi:10.1016/j.vgie.2021.05.022

Cited by 6 publications

(11 citation statements)

References 5 publications

(8 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These reasons might make snaring difficult and lead to perforation and a low resection rate. However, our previous reports revealed that the buoyancy of mucosal and submucosal layers was favorable and similar to that in underwater endoscopy based on endoscopic ultrasonography findings [19].…”

Section: Accepted Manuscriptsupporting

confidence: 79%

“…Furthermore, the viscosity of the gelatinous liquid may possibly affect the opening and closing of the snare. These issues might make snaring difficult and lead to perforation and a low resection rate; however, our previous reports revealed that the buoyancy of the mucosal and submucosal layers was favorable and similar to that in underwater endoscopy based on endoscopic ultrasonography findings [19]. Additionally, there was no difficulty in manipulating the snare.…”

Section: Giermentioning

confidence: 76%

“…(GIER), a gel-based EMR, as an alternative method to water-based UEMR, and reported its efficacy [19].…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…Yano et al reported that use of an immersing gelatinous liquid during endoscopy resulted in a favorable visual field and named this method gel immersion endoscopy 16 17 18 . Applying these features, we devised gel immersion endoscopic resection (GIER), a gel-based EMR technique, as an alternative method to water-based UEMR, and reported its efficacy 19 .…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

A feasibility study comparing gel immersion endoscopic resection and underwater endoscopic mucosal resection for superficial nonampullary duodenal epithelial tumors

et al. 2022

Self Cite

View full text Add to dashboard Cite

Background: Although gel immersion endoscopic resection (GIER) is a potential alternative to underwater endoscopic mucosal resection (UEMR) for superficial nonampullary duodenal epithelial tumor (SNADET), comparisons between the two are insufficient. Methods: Forty consecutive procedures performed in 35 patients were retrospectively reviewed; primary outcome was procedure time and secondary outcomes were en bloc and R0 resection rates, tumor and specimen size, and adverse events. Results: Lesions were divided into GIER (n = 22) and UEMR groups (n = 18). The procedure time was significantly shorter in the GIER group than that in the UEMR group (2.75 [1–3.5] min vs. 3 [2–10] min, p = 0.010). The en bloc resection rate was 100.0% in the GIER group but only 83.3% in the UEMR group. The R0 resection rate was significantly higher in the GIER group than that in the UEMR group (95.5% vs. 66.7%, p = 0.033). The specimen size was larger in the GIER group than that in the UEMR group (14 mm vs. 7.5 mm, p < 0.001). The tumor size was not significantly different between the groups and no adverse events were observed. Conclusions: GIER is efficacious and safe to treat SNADET, although additional studies are needed.

show abstract

Section: Accepted Manuscriptsupporting

confidence: 79%

Section: Giermentioning

confidence: 76%

“…(GIER), a gel-based EMR, as an alternative method to water-based UEMR, and reported its efficacy [19].…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A feasibility study comparing gel immersion endoscopic resection and underwater endoscopic mucosal resection for superficial nonampullary duodenal epithelial tumors

et al. 2022

Self Cite

View full text Add to dashboard Cite

show abstract

“…In this regard, a key advantage of using gel instead of water is that gel prevents rapid mixing with bowel fluid and narrows the working space based on the appropriate viscosity, especially in difficult anatomical locations 3–5 . Our report demonstrates that the combined use of acetic acid, NBI, and gel immersion contributes toward the complete resection of SSLs located in difficult anatomical locations.…”

Section: Brief Explanationmentioning

confidence: 75%

Gel immersion endoscopic mucosal resection with acetic acid spray for sessile serrated lesion extending close to the appendiceal orifice

Takada

Imai

2022

Digestive Endoscopy

View full text Add to dashboard Cite

show abstract

Gel Immersion Endoscopic Mucosal Resection (EMR) for Superficial Nonampullary Duodenal Epithelial Tumors May Reduce Procedure Time Compared with Underwater EMR (with Video)

Yamashina

Shimatani

Takahashi

et al. 2022

Gastroenterology Research and Practice

View full text Add to dashboard Cite

Background/Aims. Underwater endoscopic mucosal resection (UEMR) has recently attracted attention as a safe and effective method for superficial nonampullary duodenal epithelial tumors (SNADETs). However, water is a fluid and it does not remain in all areas, and because it mixes easily with other substances, it sometimes becomes cloudy and reduces visibility. A new endoscopic gel product that does not mix with fluids and tends to remain in the injected area has recently been applied to EMR and is known as gel immersion EMR (GIEMR) or under-gel EMR. Here, we evaluated the endoscopic outcomes of UEMR and GIEMR. Materials and Methods. This was a retrospective cohort study conducted in two municipal hospitals. We identified 24 patients with SNADETs of 3–18 mm in diameter who underwent UEMR or GIEMR. One lesion was excluded from the analysis because it was found to be in the stomach after surgery. The primary outcome was procedure time. Results. GIEMR significantly reduced the procedure time compared with UEMR (5 min vs. 10 min, P = 0.016 ). There was no significant difference between the UEMR and GIEMR groups for en bloc resection rate (93% vs. 100%, P = 1.0 ) and R0 resection rate (57% vs. 80%, P = 0.39 ). No serious complications were observed in either group. Conclusions. GIEMR of SNADET has the potential to reduce procedure time compared with UEMR and may be particularly effective in areas where immersion in water is difficult.

show abstract

Gel immersion endoscopy-facilitated endoscopic mucosal resection of a superficial nonampullary duodenal epithelial tumor: a novel approach

Abstract: Video Video 1 Gel immersion endoscopy-facilitated endoscopic mucosal resection of a superficial nonampullary duodenal epithelial tumor.

Cited by 6 publications

References 5 publications

A feasibility study comparing gel immersion endoscopic resection and underwater endoscopic mucosal resection for superficial nonampullary duodenal epithelial tumors

A feasibility study comparing gel immersion endoscopic resection and underwater endoscopic mucosal resection for superficial nonampullary duodenal epithelial tumors

Gel immersion endoscopic mucosal resection with acetic acid spray for sessile serrated lesion extending close to the appendiceal orifice

Gel Immersion Endoscopic Mucosal Resection (EMR) for Superficial Nonampullary Duodenal Epithelial Tumors May Reduce Procedure Time Compared with Underwater EMR (with Video)

Contact Info

Product

Resources

About