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CC BY-NC-ND 4.0 · Endosc Int Open 2022; 10(09): E1302-E1306
DOI: 10.1055/a-1894-0719
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Gel immersion endoscopic submucosal dissection: clinical experience with 13 cases of superficial esophageal cancer

Yuya Nakano
1   Department of Gastroenterology, Saitama Medical University International Medical Center, Saitama, Japan
,
Tomoaki Tashima
1   Department of Gastroenterology, Saitama Medical University International Medical Center, Saitama, Japan
,
Ryuhei Jinushi
1   Department of Gastroenterology, Saitama Medical University International Medical Center, Saitama, Japan
,
Rie Terada
1   Department of Gastroenterology, Saitama Medical University International Medical Center, Saitama, Japan
,
Yumi Mashimo
1   Department of Gastroenterology, Saitama Medical University International Medical Center, Saitama, Japan
,
Tomonori Kawasaki
2   Department of Pathology, Saitama Medical University International Medical Center, Saitama, Japan
,
Toshio Uraoka
3   Department of Gastroenterology and Hepatology, Graduate School of Medicine, Gunma University, Gunma, Japan.
,
Shomei Ryozawa
1   Department of Gastroenterology, Saitama Medical University International Medical Center, Saitama, Japan
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Abstract

Esophageal endoscopic submucosal dissection (ESD) of tumors located on the gravity side is technically challenging. Given that gel immersion ESD (GIESD) is performed by immersing lesions in gel, we hypothesized that it could be used to eliminate the disadvantage associated with submerging the gravity side. Here, we performed GIESD using VISCOCLEAR for superficial esophageal cancer on the gravity side of the esophagus, with monopolar devices. This study aimed to evaluate the short-term outcomes of GIESD for superficial esophageal cancer. Fifteen patients with 16 superficial esophageal cancers underwent GIESD by a single operator, and 13 cases were evaluated. All patients were male, and GIESD was performed in the middle (12/13, 92.3 %) and lower (1/13, 7.7 %) thoracic esophagus. The lesions were located on the left (7/13, 53.8 %), posterior (5/13, 38.5 %), and right (1/13, 7.7 %) esophageal walls. The median procedure time was 27 minutes (interquartile range [IQR], 14–68), and the median dissection speed was 20 mm2/min (IQR, 14–25.7). The median amount of gel used was 400 mL (IQR, 360–580), and no gel-related adverse events were observed. The median total dose of midazolam was 3 mg (IQR, 2–5). GIESD was completed with en bloc and R0 resections achieved in 100 % of the 13 cases. Delayed adverse events, such as bleeding or perforation, did not occur (0/13, 0 %).



Publikationsverlauf

Eingereicht: 25. Februar 2022

Angenommen nach Revision: 04. Juli 2022

Accepted Manuscript online:
07. Juli 2022

Artikel online veröffentlicht:
14. September 2022

© 2022. 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/)

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Endoscopy International Open – recently publishedEndoscopy 2022; 54(10): 1020-1020
DOI: 10.1055/a-1852-8518

 

  • References

  • 1 Hazama H, Tanaka M, Kakushima N. et al. Predictors of technical difficulty during endoscopic submucosal dissection of superficial esophageal cancer. Surg Endosc 2019; 33: 2909-2915
    CrossrefPubMedSuche in Google Scholar
  • 2 Yano T, Nemoto D, Ono K. et al. Gel immersion endoscopy: A novel method to secure the visual field during endoscopy in bleeding patients (with videos). Gastrointest Endosc 2016; 83: 809-811
    Suche in Google Scholar
  • 3 Akasaka T, Takeuchi Y, Ishida H. et al. A novel gel immersion technique using a bipolar needle-knife in endoscopic submucosal dissection for superficial gastrointestinal neoplasms. Ann Gastroenterol 2018; 31: 247
    PubMedSuche in Google Scholar
  • 4 Yano T, Takezawa T, Hashimoto K. et al. Gel immersion endoscopy: Innovation in securing the visual field – clinical experience with 265 consecutive procedures. Endosc Int Open 2021; 9: E1123-E1127
    Thieme ConnectPubMedSuche in Google Scholar
  • 5 Miyamoto S, Suzuki K, Kinoshita K. Efficiency of a novel gel product for duodenal ulcer bleeding. Dig Endosc 2021; 33: e63-e64
    CrossrefPubMedSuche in Google Scholar
  • 6 American Society of Anesthesiologists Task Force on Sedation and Analgesia by Non-Anesthesiologists. Practice guidelines for sedation and analgesia by non-anesthesiologists. Anesthesiology 2002; 96: 1004-1017
    CrossrefPubMedSuche in Google Scholar
  • 7 Hamada K, Kawano K, Yamauchi A. et al. Efficacy of endoscopic submucosal dissection of esophageal neoplasms under general anesthesia. Clin Endosc 2019; 52: 252-257
    CrossrefPubMedSuche in Google Scholar
  • 8 Yano K, Yano T, Nagayama M. et al. Hemostasis of an actively bleeding lesion at the ileocecal valve by low-pressure endoscopy using the gel immersion technique. VideoGIE 2021; 6: 184-186
    CrossrefPubMedSuche in Google Scholar
  • 9 Nakano Y, Tashima T, Ryozawa S. et al. Conversion from conventional esophageal endoscopic submucosal dissection to the gel immersion method. Endosc Int Open 2021; 12: E1756-E1757
    PubMedSuche in Google Scholar