CC BY-NC-ND 4.0 · Endosc Int Open 2021; 09(05): E653-E658
DOI: 10.1055/a-1372-3740
Original article

Colorectal endoscopic submucosal dissection using the pocket-creation method with single clip traction: a feasibility study

Tatsuma Nomura
1   Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan
,
Yoshikazu Hayashi
1   Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan
,
Takaaki Morikawa
1   Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan
,
Masahiro Okada
1   Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan
,
Hisashi Fukuda
1   Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan
,
Takahito Takezawa
1   Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan
,
Keijiro Sunada
1   Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan
,
Alan Kawarai Lefor
2   Department of Surgery, Jichi Medical University, Shimotsuke, Japan
,
Hironori Yamamoto
1   Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan
› Institutsangaben

Abstract

Background and study aims The pocket-creation method (PCM) facilitates dissection of the central part of a tumor. We previously developed the PCM with clip traction (PCM-CT) to facilitate opening the mucosal pocket, which otherwise could become cumbersome. In the present study, we aimed to examine the feasibility of PCM-CT for colorectal endoscopic submucosal dissection (ESD).

Patients and methods PCM-CT was performed on 30 patients with early colorectal tumors from October 2019 to April 2020. PCM-CT allows efficient opening of the mucosal pocket by using the PCM to dissect the center of the lesion and then apply traction with a single clip after making a circumferential mucosal incision.

Results The median specimen major axis length, ESD time, ESD speed, and en bloc resection rate were 48 mm, 84 minutes, 20 mm2/min, and 100 % (30/30), respectively. The success rates for the traction clip and median single-clip-traction time were 100 % (30/30) and 1.5 minutes, respectively.

Conclusions Colorectal ESD using PCM-CT is a simple and promising method.



Publikationsverlauf

Eingereicht: 13. September 2020

Angenommen: 09. Dezember 2020

Artikel online veröffentlicht:
22. 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 Jawaid S, Yang D, Draganov PV. Tissue retractor system-assisted endoscopic submucosal dissection of a large rectal tumor with significant fibrosis from direct tattooing. VideoGIE 2019; 4: 84-86
  • 2 Sakamoto N, Osada T, Shibuya T. et al. The facilitation of a new traction device (S-O clip) assisting endoscopic submucosal dissection for superficial colorectal neoplasms. Endoscopy 2008; 40: E94-E95
  • 3 Moss A, Williams SJ, Hourigan LF. et al. Long-term adenoma recurrence following wide-field endoscopic mucosal resection (WF-EMR) for advanced colonic mucosal neoplasia is infrequent: results and risk factors in 1000 cases from the Australian Colonic EMR (ACE) study. Gut 2015; 64: 57-65
  • 4 Hayashi Y, Miura Y, Yamamoto H. Pocket-creation method for the safe, reliable, and efficient endoscopic submucosal dissection of colorectal lateral spreading tumors. Dig Endosc 2015; 27: 534-535
  • 5 Hayashi Y, Sunada K, Takahashi H. et al. Pocket-creation method of endoscopic submucosal dissection to achieve en bloc resection of giant colorectal subpedunculated neoplastic lesions. Endoscopy 2014; 46: E421-E422
  • 6 Nomura T, Hayashi Y, Lee RF. et al. Pocket-creation method using a new technique of single-clip traction for colorectal endoscopic submucosal dissection. Endoscopy 2020; 52: E208-E210
  • 7 Yamashina T, Hayashi Y, Sakamoto H. et al. Balloon-assisted endoscopy facilitates endoscopic submucosal dissection of difficult superficial proximal colon tumors. Endoscopy 2018; 50: 800-808
  • 8 Okamoto Y, Oka S, Tanaka S. et al. Clinical usefulness of the S-O clip during colorectal endoscopic submucosal dissection in difficult-to-access submucosal layer. Endosc Int Open 2020; 8: E437-E449
  • 9 Jacques J, Charissoux A, Legros R. et al. Double clip counter traction using a rubber band is a useful and adaptive tool for colonic endoscopic submucosal dissection. Endoscopy 2018; 50: 179-181
  • 10 Nomura T, Miura Y, Yamamoto H. Novel approach to training novices in endoscopic submucosal dissection: The Master-Apprentice Technique. Dig Endosc 2020; 32: e30-e31
  • 11 Matsumoto A, Tanaka S, Oba S. et al. Outcome of endoscopic submucosal dissection for colorectal tumors accompanied by fibrosis. Scand J Gastroenterol 2010; 45: 1329-1337
  • 12 Yamashina T, Hayashi Y, Fukuda H. et al. The pocket-creation method may facilitate endoscopic submucosal dissection of large colorectal sessile tumors. Endosc Int Open 2020; 8: E1021
  • 13 Yamashina T, Nemoto D, Hayashi Y. et al. Prospective randomized trial comparing the pocket-creation method and conventional method of colorectal endoscopic submucosal dissection. Gastrointest Endosc 2020; DOI: 10.1016/j.gie.2020.02.034.
  • 14 Sakamoto H, Hayashi Y, Miura Y. et al. Pocket-creation method facilitates endoscopic submucosal dissection of colorectal laterally spreading tumors, non-granular type. Endosc Int Open 2017; 5: E123-E129
  • 15 Ismail MS, Bahdi F, Mercado MO. et al. ESD with double-balloon endoluminal intervention platform versus standard ESD for management of colon polyps. Endosc Int Open 2020; 8: E1273-E1279
  • 16 Yamasaki Y, Takeuchi Y, Uedo N. et al. Efficacy of traction-assisted colorectal endoscopic submucosal dissection using a clip-and-thread technique: a prospective randomized study. Dig Endosc 2018; 30: 467-476
  • 17 Hashimoto R, Hirasawa D, Iwaki T. et al. Usefulness of the S-O clip for gastric endoscopic submucosal dissection (with video). Surg Endosc 2018; 32: 908-914
  • 18 Matsuzaki I, Hattori M, Yamauchi H. et al. Magnetic anchor-guided endoscopic submucosal dissection for colorectal tumors (with video). Surg Endosc 2020; 34: 1012-1018
  • 19 Nomura T, Hayashi Y, Yamamoto H. Pocket-creation method with pulley clip elastic line traction for large rectal tumors. Dig Endosc 2020; DOI: 10.1111/den.13749.