Mathieu Pioche1,2,3, Vincent Lépilliez4, Mihai Ciocîrlan4,5, Jérôme Rivory4, Clothilde Miaglia4, Valérie Hervieu6, Gilles Poncet7, Pierre-Jean Valette8, Jean-Christophe Saurin4, Thierry Ponchon4,9. 1. Gastroenterology and Endoscopy, Edouard Herriot Hospital, Lyon Cedex, France. mathieupioche@free.fr. 2. Nestis, Lyon, France. mathieupioche@free.fr. 3. LabTau, Inserm U1032, Lyon Cedex, France. mathieupioche@free.fr. 4. Gastroenterology and Endoscopy, Edouard Herriot Hospital, Lyon Cedex, France. 5. Fundeni Gastroenterology Clinic, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania. 6. Pathology Department, Edouard Herriot Hospital, Lyon, France. 7. Visceral Surgery Department, Edouard Herriot Hospital, Lyon Cedex, France. 8. Digestive Radiology Department, Edouard Herriot Hospital, Lyon Cedex, France. 9. LabTau, Inserm U1032, Lyon Cedex, France.
Abstract
BACKGROUND: The Enki-2 water jet system (Nestis SAS®, Lyon, France) with dual injection and dissection capability significantly reduced ESD procedure time and perforation rates in animal studies. The study aim was to evaluate its efficacy and safety in patients with superficial neoplastic lesions. METHODS: A prospective study including 18 patients with esophageal, gastric and rectal superficial neoplasms treated by ESD using Enki-2 was designed. RESULTS: Eighteen lesions (6 esophageal, 3 gastric, 9 rectal, mean diameter 43.5 mm) in 17 patients (10 men, mean age 65.9) were included. The mean procedure time was 65.6 min. One patient needed clipping for an incomplete muscle tear during procedure; there were neither delayed bleedings nor perforation. The "en bloc" resection rate was 100 %, the R0 resection rate was 88.9 % (16/18 lesions), and the curative resection rate was 77.8 %. The 3-month disease-free rate was 92.3 % (12/13 patients, 13/14 lesions, 1 patient lost to follow-up). The 12-month disease-free rate was 69.2 % (9/13 patients, 10/14 lesions, 4 patients lost to follow-up). CONCLUSIONS: ESD with Enki-2 water jet system is effective and safe for superficial neoplastic digestive lesions.
BACKGROUND: The Enki-2 water jet system (Nestis SAS®, Lyon, France) with dual injection and dissection capability significantly reduced ESD procedure time and perforation rates in animal studies. The study aim was to evaluate its efficacy and safety in patients with superficial neoplastic lesions. METHODS: A prospective study including 18 patients with esophageal, gastric and rectal superficial neoplasms treated by ESD using Enki-2 was designed. RESULTS: Eighteen lesions (6 esophageal, 3 gastric, 9 rectal, mean diameter 43.5 mm) in 17 patients (10 men, mean age 65.9) were included. The mean procedure time was 65.6 min. One patient needed clipping for an incomplete muscle tear during procedure; there were neither delayed bleedings nor perforation. The "en bloc" resection rate was 100 %, the R0 resection rate was 88.9 % (16/18 lesions), and the curative resection rate was 77.8 %. The 3-month disease-free rate was 92.3 % (12/13 patients, 13/14 lesions, 1 patient lost to follow-up). The 12-month disease-free rate was 69.2 % (9/13 patients, 10/14 lesions, 4 patients lost to follow-up). CONCLUSIONS: ESD with Enki-2 water jet system is effective and safe for superficial neoplastic digestive lesions.
Entities:
Keywords:
Endoscopic submucosal dissection; Superficial neoplasia; Water jet system
Authors: S Farhat; S Chaussade; T Ponchon; D Coumaros; A Charachon; T Barrioz; S Koch; P Houcke; C Cellier; D Heresbach; V Lepilliez; B Napoleon; P Bauret; E Coron; M Le Rhun; P Bichard; E Vaillant; A Calazel; E Bensoussan; S Bellon; L Mangialavori; F Robin; F Prat Journal: Endoscopy Date: 2011-05-27 Impact factor: 10.093
Authors: N Yahagi; H Neuhaus; B Schumacher; A Neugebauer; G F Kaehler; M Schenk; K Fischer; M Fujishiro; M D Enderle Journal: Endoscopy Date: 2009-04-01 Impact factor: 10.093
Authors: Mihai Ciocîrlan; Mathieu Pioche; Vincent Lepilliez; Nicolas Gonon; Roland Roume; Guillaume Noel; Christian Pinset; Thierry Ponchon Journal: Endoscopy Date: 2013-10-25 Impact factor: 10.093