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.
