Yasuharu Okamoto1, Ryu Nakadate2, Shotaro Nakamura3, Jumpei Arata4, Susumu Oguri5, Tomohiko Moriyama1, Motohiro Esaki1, Tsutomu Iwasa2,6, Kenoki Ohuchida5,7, Tomohiko Akahoshi5, Tetsuo Ikeda5, Takanari Kitazono1, Makoto Hashizume8,9,10. 1. Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. 2. Center for Advanced Medical Innovation, Kyushu University, Fukuoka, Japan. 3. Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University, Morioka, Japan. 4. Department of Mechanical Engineering, Faculty of Engineering, Kyushu University, Fukuoka, Japan. 5. Department of Advanced Medical Initiatives, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. 6. Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. 7. Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. 8. Center for Advanced Medical Innovation, Kyushu University, Fukuoka, Japan. mhashi@dem.med.kyushu-u.ac.jp. 9. Department of Advanced Medical Initiatives, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. mhashi@dem.med.kyushu-u.ac.jp. 10. Department of Advanced Medical Initiatives, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. mhashi@dem.med.kyushu-u.ac.jp.
Abstract
BACKGROUND AND AIMS: Colonic endoscopic submucosal dissection (ESD) is time-consuming and bears a high risk of perforation. The aim of the present study was to compare the safety and efficacy between novel articulating devices and conventional ESD in live porcine colon models. METHODS: Thirty ESDs in ten pigs were carried out at three different locations (15, 25, and 35 cm from the anus) by the conventional method (n = 15) and by the new method (n = 15). Procedure times, adverse events (perforation, bleeding), and damage to the muscular layer were recorded, and the ESD time per unit area of the specimens was calculated. RESULTS: The perforation rate using the conventional method was 6.7% (1/15), whereas that using the new method was 0.0%. The number of sites of muscular damage was significantly lower in the new than conventional method (6 vs. 37, respectively; P = 0.024). The mean procedure time was significantly shorter in the new than conventional method (4.6 ± 2.0 vs. 7.0 ± 4.1 min/cm2, respectively; P = 0.042). CONCLUSIONS: Use of the new ESD method allows for reduced adverse events and a shortened resection time.
BACKGROUND AND AIMS: Colonic endoscopic submucosal dissection (ESD) is time-consuming and bears a high risk of perforation. The aim of the present study was to compare the safety and efficacy between novel articulating devices and conventional ESD in live porcine colon models. METHODS: Thirty ESDs in ten pigs were carried out at three different locations (15, 25, and 35 cm from the anus) by the conventional method (n = 15) and by the new method (n = 15). Procedure times, adverse events (perforation, bleeding), and damage to the muscular layer were recorded, and the ESD time per unit area of the specimens was calculated. RESULTS: The perforation rate using the conventional method was 6.7% (1/15), whereas that using the new method was 0.0%. The number of sites of muscular damage was significantly lower in the new than conventional method (6 vs. 37, respectively; P = 0.024). The mean procedure time was significantly shorter in the new than conventional method (4.6 ± 2.0 vs. 7.0 ± 4.1 min/cm2, respectively; P = 0.042). CONCLUSIONS: Use of the new ESD method allows for reduced adverse events and a shortened resection time.
Authors: John T Maple; Barham K Abu Dayyeh; Shailendra S Chauhan; Joo Ha Hwang; Sri Komanduri; Michael Manfredi; Vani Konda; Faris M Murad; Uzma D Siddiqui; Subhas Banerjee Journal: Gastrointest Endosc Date: 2015-03-18 Impact factor: 9.427