Download PDF
CC BY-NC-ND 4.0 · Endosc Int Open 2017; 05(07): E670-E674
DOI: 10.1055/s-0043-111720
Original article
Eigentümer und Copyright ©Georg Thieme Verlag KG 2017

Evaluation of endoscopic submucosal dissection using a new endosurgical knife DN-D2718B: a first clinical feasibility study

Yoshiki Sakaguchi
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
,
Yosuke Tsuji
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
,
Mitsuhiro Fujishiro
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
2   Department of Endoscopy and Endoscopic Surgery, Graduate School of Medicine, The University of Tokyo,Tokyo, Japan
,
Yosuke Kataoka
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
,
Itaru Saito
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
,
Satoki Shichijo
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
,
Chihiro Minatsuki
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
,
Itsuko Asada-Hirayama
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
,
Daisuke Yamaguchi
2   Department of Endoscopy and Endoscopic Surgery, Graduate School of Medicine, The University of Tokyo,Tokyo, Japan
,
Keiko Niimi
3   Center for Epidemiology and Preventive Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
,
Satoshi Ono
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
,
Shinya Kodashima
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
,
Nobutake Yamamichi
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
,
Kazuhiko Koike
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
› Author Affiliations
Further Information

Publication History

submitted 21 September 2016

accepted after revision 29 March 2017

Publication Date:
06 July 2017 (online)

Also available at
   Permissions and Reprints

Abstract

Background and study aims Endosurgical devices with injection function have been reported to decrease endoscopic submucosal dissection (ESD) operation times for experts, but the efficacy of these devices for inexperienced endoscopists is unclear. The aim of this study was to evaluate the feasibility of ESD using a novel ESD knife (DN-D2718B).

Patients and methods This is a single-center prospective pilot clinical feasibility study. Patients diagnosed with superficial gastrointestinal neoplasms were enrolled. A pre-specified group of ESD trainees with ESD experience on a porcine gastric model and fewer than 30 cases of ESD in their selected fields performed ESD under expert supervision, using the DN-D2718B. En bloc resection rates, R0 resection rates, procedure times, and incidence of intra-operational/post-operational adverse events were assessed.

Results Between June 2015 and January 2016, 13 esophageal, 27 gastric, and 14 colorectal ESD cases were performed per-protocol with mean resection speeds of 10.2, 12.0, and 15.5 mm2/min, respectively. There were no intra-operational complications.

Conclusion ESD with this novel knife is feasible even when performed by non-experts.

 

  • References

  • 1 Tanaka S, Kashida H, Saito Y. et al. JGES guidelines for colorectal endoscopic submucosal dissection/endoscopic mucosal resection. Dig Endosc 2015; 27: 417-434
    CrossrefPubMedSearch in Google Scholar
  • 2 Pimentel-Nunes P, Dinis-Ribeiro M, Ponchon T. et al. Endoscopic submucosal dissection: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2015; 47: 829-854
    Thieme ConnectPubMedSearch in Google Scholar
  • 3 Saito Y, Uraoka T, Yamaguchi Y. et al. A prospective, multicenter study of 1111 colorectal endoscopic submucosal dissections (with video). Gastrointest Endosc 2010; 72: 1217-1225
    CrossrefPubMedSearch in Google Scholar
  • 4 Ciocîrlan M, Pioche M, Lepilliez V. et al. The ENKI-2 water-jet system versus Dual Knife for endoscopic submucosal dissection of colorectal lesions: a randomized comparative animal study. Endoscopy 2014; 46: 139-143
    Thieme ConnectPubMedSearch in Google Scholar
  • 5 Imai K, Hotta K, Yamaguchi Y. et al. Preoperative indicators of failure of en bloc resection or perforation in colorectal endoscopic submucosal dissection: implications for lesion stratification by technical difficulties during stepwise training. Gastrointest Endosc 2016; 83: 954-962
    CrossrefPubMedSearch in Google Scholar
  • 6 Fujishiro M, Sugita N. Animal feasibility study of an innovated splash-needle for endoscopic submucosal dissection in the upper gastrointestinal tract. Dig Endosc 2013; 25: 7-12
    PubMedSearch in Google Scholar
  • 7 Tsuji Y, Ohata K, Sekiguchi M. et al. An effective training system for endoscopic submucosal dissection of gastric neoplasm. Endoscopy 2011; 43: 1033-1038
    Thieme ConnectPubMedSearch in Google Scholar
  • 8 Yoshida M, Kakushima N, Mori K. et al. Learning curve and clinical outcome of gastric endoscopic submucosal dissection performed by trainee operators. Surg Endosc 2016;
    CrossrefPubMedSearch in Google Scholar
  • 9 Ono S, Fujishiro M, Koike K. Endoscopic submucosal dissection for superficial esophageal neoplasms. World J Gastrointest Endosc 2012; 4: 162-166
    CrossrefPubMedSearch in Google Scholar
  • 10 Sakaguchi Y, Tsuji Y, Ono S. et al. Polyglycolic acid sheets with fibrin glue can prevent esophageal stricture after endoscopic submucosal dissection. Endoscopy 2015; 47: 336-340
    Thieme ConnectPubMedSearch in Google Scholar
  • 11 Okamoto K, Kitamura S, Muguruma N. et al. Mucosectom2-short blade for safe and efficient endoscopic submucosal dissection of colorectal tumors. Endoscopy 2013; 45: 928-930
    Thieme ConnectPubMedSearch in Google Scholar
  • 12 Kawahara Y, Hori K, Takenaka R. et al. Endoscopic submucosal dissection of esophageal cancer using the Mucosectom2 device: a feasibility study. Endoscopy 2013; 45: 869-875
    Thieme ConnectPubMedSearch in Google Scholar
  • 13 Park YM, Cho E, Kang HY. et al. The effectiveness and safety of endoscopic submucosal dissection compared with endoscopic mucosal resection for early gastric cancer: a systematic review and metaanalysis. Surg Endosc 2011; 25: 2666-2677
    CrossrefPubMedSearch in Google Scholar
  • 14 Arezzo A, Passera R, Marchese N. et al. Systematic review and meta-analysis of endoscopic submucosal dissection vs endoscopic mucosal resection for colorectal lesions. United European Gastroenterol J 2016; 4: 18-29
    CrossrefPubMedSearch in Google Scholar
  • 15 Kim JS, Kim BW, Shin IS. Efficacy and safety of endoscopic submucosal dissection for superficial squamous esophageal neoplasia: a meta-analysis. Dig Dis Sci 2014; 59: 1862-1869
    CrossrefPubMedSearch in Google Scholar