Download PDF
CC BY-NC-ND 4.0 · Endosc Int Open 2021; 09(04): E606-E609
DOI: 10.1055/a-1352-3805
Original article

Feasibility of ultrathin endoscope for esophageal endoscopic submucosal dissection

Daisuke Kikuchi
Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan
,
Masami Tanaka
Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan
,
Satoshi Nakamura
Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan
,
Kosuke Nomura
Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan
,
Junnosuke Hayasaka
Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan
,
Yorinari Ochiai
Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan
,
Hiroyuki Odagiri
Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan
,
Satoshi Yamashita
Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan
,
Akira Matsui
Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan
,
Shu Hoteya
Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Abstract

Background and study aims Endoscopic submucosal dissection (ESD) is widely performed for superficial esophageal cancer, but stricture after extensive resection is a major clinical problem. Using an ultrathin endoscope would enable endoscopists to approach lesions beyond the stricture. We evaluated the feasibility of an ultrathin endoscope for esophageal ESD.

Methods To perform ESD with an ultrathin endoscope, we developed a transparent hood and ESD knife. A total of 24 esophageal ESDs were performed by two endoscopists with excised and live porcine esophaguses. A GIF-Q260 J and Dual knife were used in the conventional group and the GIF-XP260NS and a newly developed knife were used in the ultrathin group. En bloc resection rates, perforation rates, and procedure times were compared.

Results All 24 lesions were resected en bloc without perforation. The mean procedure time was longer in the ultrathin group, although not significantly so (274.3 ± 81.8 s vs 435.8 ± 313.9 s, respectively; P = 0.22).

Conclusion Although the procedure time was longer in the ultrathin group, en bloc resection was performed without any perforation. The findings indicate that esophageal ESD with an ultrathin endoscope is feasible.



Publication History

Received: 31 August 2020

Accepted: 07 December 2020

Article published online:
13 April 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Hoteya S, Iizuka T, Kikuchi D. et al. Benefits of endoscopic submucosal dissection according to size and location of gastric neoplasm, compared with conventional mucosal resection. J Gastroenterol Hepatol 2009; 24: 1102-1106
    CrossrefPubMedSearch in Google Scholar
  • 2 Yamaguchi N, Isomoto H, Nakayama T. et al. Usefulness of oral prednisolone in the treatment of esophageal stricture after endoscopic submucosal dissection for superficial esophageal squamous cell carcinoma. Gastrointest Endosc 2011; 73: 1115-1121
    CrossrefPubMedSearch in Google Scholar
  • 3 Hanaoka N, Ishihara R, Takeuchi Y. et al. Intralesional steroid injection to prevent stricture after endoscopic submucosal dissection for esophageal cancer: a controlled prospective study. Endoscopy 2012; 44: 1007-1011
    Thieme ConnectPubMedSearch in Google Scholar
  • 4 Iizuka T, Kikuchi D, Yamada A. et al. Polyglycolic acid sheet application to prevent esophageal stricture after endoscopic submucosal dissection for esophageal squamous cell carcinoma. Endoscopy 2015; 47: 341-344
    PubMedSearch in Google Scholar
  • 5 Ohki T, Yamato M, Ota M. et al. Prevention of esophageal stricture after endoscopic submucosal dissection using tissue-engineered cell sheets. Gastroenterology 2012; 143: 582-588
    CrossrefPubMedSearch in Google Scholar
  • 6 Kawai T, Yanagizawa K, Naito S. et al. Evaluation of gastric cancer diagnosis using new ultrathin transnasal endoscopy with narrow-band imaging: preliminary study. J Gastroenterol Hepatol 2014; 29: 33-36
    CrossrefPubMedSearch in Google Scholar
  • 7 Suzuki T, Kitagawa Y, Nankinzan R. et al. Early gastric cancer diagnostic ability of ultrathin endoscope loaded with laser light source. World J Gastroenterol 2019; 25: 1378-1386
    CrossrefPubMedSearch in Google Scholar
  • 8 Shi KD, Ji F. Prophylactic stenting for esophageal stricture prevention after endoscopic submucosal dissection. World J Gastroenterol 2017; 23: 931-934
    CrossrefPubMedSearch in Google Scholar
  • 9 Katada C, Yokoyama T, Yano T. et al. Association between macrocytosis and metachronous squamous cell carcinoma of the esophagus after endoscopic resection in men with early esophageal squamous cell carcinoma. Esophagus 2020; 17: 149-158
    CrossrefPubMedSearch in Google Scholar
  • 10 Endo H, Inamori M, Murakami T. et al. Usefulness of transnasal ultrathin endoscopy for the placement of a postpyloric decompression tube. Digestion 2007; 75: 181
    CrossrefPubMedSearch in Google Scholar
  • 11 Nakamura M, Shibata T, Tahara T. et al. Usefulness of transnasal endoscopy where endoscopic submucosal dissection is difficult. Gastric Cancer 2011; 14: 378-384
    CrossrefPubMedSearch in Google Scholar
  • 12 Ahn JY, Choi KD, Lee JH. et al. Is transnasal endoscope-assisted endoscopic submucosal dissection for gastric neoplasm useful in training beginners? A prospective randomized trial. Surg Endosc 2013; 27: 1158-1165
    CrossrefPubMedSearch in Google Scholar
  • 13 Kamamura M, Shiroeda H, Tahara T. et al. Endoscopic submucosal dissection of an esophageal tumor using a transnasal endoscope without sedation. Endoscopy 2014; 46 (Suppl. 01) E115-E116
    Thieme ConnectPubMedSearch in Google Scholar
  • 14 Miura Y, Hayashi Y, Lefor AK. et al. The pocket-creation method of ESD for gastric neoplasms. Gastrointest Endosc 2016; 83: 457-458
    CrossrefPubMedSearch in Google Scholar
  • 15 Kikuchi D, Tanaka M, Suzuki Y. et al. Endoscopic submucosal dissection for superficial pharyngeal carcinoma using transnasal endoscope. VideoGIE 2021; 6: 67-70
    CrossrefPubMedSearch in Google Scholar
  • 16 Inoue H, Minami H, Kobayashi Y. et al. Peroral endoscopic myotomy (POEM) for esophageal achalasia. Endoscopy 2010; 42: 265-271
    Thieme ConnectPubMedSearch in Google Scholar