Shunsuke Yoshii1, Tomofumi Akasaka2, Yoshito Hayashi1, Yoshiki Tsujii1, Kengo Nagai1, Koji Higashino2, Ryu Ishihara2, Hideki Iijima1, Tetsuo Takehara3. 1. Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, Japan. 2. Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan. 3. Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, Japan. takehara@gh.med.osaka-u.ac.jp.
Abstract
BACKGROUND: Despite improvements in therapeutic strategy and instrumentation in colorectal endoscopic submucosal dissection (ESD), adverse events sometimes occur. Further advancements in available techniques are required to improve procedural success rates and safety. We developed a novel method for ESD in saline, referred to as "underwater" ESD (UESD). UESD involves using a bipolar needle knife and aims to enable complete resection while minimizing thermal damage to the muscle layer. In this study, we evaluated the safety and efficacy of this new technique. METHODS: This was a retrospective study using data from two referral centers and included 40 lesions diagnosed as colorectal epithelial neoplasia (> 20 mm in diameter or with severe fibrosis) and treated with UESD between December 2015 and March 2017. The main outcome measures were technical success rate, incidence of adverse events, and feasibility of histologic evaluation of the resected specimens. RESULTS: All 40 lesions, including those with submucosal fibrosis, underwent successful en bloc resection using the UESD technique. No procedural adverse events including perforation, delayed bleeding, and electrocoagulation syndrome were observed, and all patients had an uneventful clinical course associated with UESD. In all cases, UESD provided a resected specimen adequate for histological evaluation, without unwarranted burn effect to the tissues. CONCLUSIONS: Our UESD technique was safe and effective for complete resection of colorectal epithelial neoplasia.
BACKGROUND: Despite improvements in therapeutic strategy and instrumentation in colorectal endoscopic submucosal dissection (ESD), adverse events sometimes occur. Further advancements in available techniques are required to improve procedural success rates and safety. We developed a novel method for ESD in saline, referred to as "underwater" ESD (UESD). UESD involves using a bipolar needle knife and aims to enable complete resection while minimizing thermal damage to the muscle layer. In this study, we evaluated the safety and efficacy of this new technique. METHODS: This was a retrospective study using data from two referral centers and included 40 lesions diagnosed as colorectal epithelial neoplasia (> 20 mm in diameter or with severe fibrosis) and treated with UESD between December 2015 and March 2017. The main outcome measures were technical success rate, incidence of adverse events, and feasibility of histologic evaluation of the resected specimens. RESULTS: All 40 lesions, including those with submucosal fibrosis, underwent successful en bloc resection using the UESD technique. No procedural adverse events including perforation, delayed bleeding, and electrocoagulation syndrome were observed, and all patients had an uneventful clinical course associated with UESD. In all cases, UESD provided a resected specimen adequate for histological evaluation, without unwarranted burn effect to the tissues. CONCLUSIONS: Our UESD technique was safe and effective for complete resection of colorectal epithelial neoplasia.
Authors: Felix W Leung; Arnaldo Amato; Christian Ell; Shai Friedland; Judith O Harker; Yu-Hsi Hsieh; Joseph W Leung; Surinder K Mann; Silvia Paggi; Jürgen Pohl; Franco Radaelli; Francisco C Ramirez; Rodelei Siao-Salera; Vittorio Terruzzi Journal: Gastrointest Endosc Date: 2012-09 Impact factor: 9.427
Authors: Paolo Cecinato; Matteo Lucarini; Chiara Campanale; Francesco Azzolini; Fabio Bassi; Romano Sassatelli Journal: Endosc Int Open Date: 2022-09-14