Endoscopic submucosal dissection of early colorectal tumors using a grasping-type scissors forceps: a preliminary clinical study

To reduce the risk of complications related to endoscopic submucosal dissection (ESD), we developed a new grasping-type scissors forceps (GSF), which can grasp and incise the targeted tissue using an electrosurgical current. We prospectively evaluated the efficacy and safety of ESD using GSF for the removal of colorectal tumors in 10 consecutive patients. After the submucosa had been injected with a solution, the lesion was separated from the surrounding normal mucosa by complete incision around the lesion using the GSF. A piece of submucosal tissue was grasped and cut with the GSF using an electrosurgical current to achieve submucosal excision. All lesions were treated easily and safely with no unexpected incisions. No delayed hemorrhage or perforation occurred. En bloc resection was obtained in all cases. The tumor-free lateral/basal margins were obtained in eight out of 10 patients. ESD using GSF appears to be an easy, safe, and technically efficient method for resecting early colorectal tumors.

References

• 1 Fujishiro M, Yahagi N, Kakushima N. et al . Outcomes of endoscopic submucosal dissection for colorectal epithelial neoplasms in 200 consecutive cases.  Clin Gastroenterol Hepatol. 2007;  5 678-683
• 2 Saito Y, Uraoka T, Matsuda K. et al . Endoscopic treatment of large superficial colorectal tumors: a case series of 200 endoscopic submucosal dissections.  Gastrointest Endosc. 2007;  66 966-973
• 3 Tanaka S, Oka S, Kaneko I. et al . Endoscopic submucosal dissection for colorectal neoplasia: possibility of standardization.  Gastrointest Endosc. 2007;  66 100-107
• 4 Kakushima N, Fujishiro M. Endoscopic submucosal resection for gastrointestinal neoplasms.  World J Gastroenterol. 2008;  14 2962-2967
• 5 Yoshida N, Wakabayashi N, Kanemasa K. et al . Endoscopic submucosal dissection for colorectal tumors: technical difficulties and rate of perforation.  Endoscopy. 2009;  41 758-761
• 6 Akahoshi K, Akahane H, Murata A. et al . Endoscopic submucosal dissection using a novel grasping type scissors forceps.  Endoscopy. 2007;  39 1103-1105
• 7 Akahoshi K, Honda K, Akahane H. et al . Endoscopic submucosal dissection using a grasping type scissors forceps: a preliminary clinical study.  Gastrointest Endosc. 2008;  67 1128-1133
• 8 Takeuchi Y, Uedo N, Ishihara R. et al . Efficacy of an endo-knife with a water-jet function (Flushknife) for endoscopic submucosal dissection of superficial colorectal neoplasms.  Am J Gastroenterol. 2009;  DOI: DOI: 10.1038/ajg.2009.547