An Electrosurgical Endoknife with a Water-Jet Function (Flushknife) Proves Its Merits in Colorectal Endoscopic Submucosal Dissection Especially for the Cases Which Should Be Removed En Bloc
Background. Previously, we reported that the Flushknife (electrosurgical endoknife with a water-jet function) could reduce the operation time of colorectal endoscopic submucosal dissection (ESD) however, suitable situation for the Flushknife was obscure. This subgroup analysis of a prospective rando...
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2013-01-01
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Series: | Gastroenterology Research and Practice |
Online Access: | http://dx.doi.org/10.1155/2013/530123 |
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author | Yoji Takeuchi Toshio Shimokawa Ryu Ishihara Hiroyasu Iishi Noboru Hanaoka Koji Higashino Noriya Uedo |
author_facet | Yoji Takeuchi Toshio Shimokawa Ryu Ishihara Hiroyasu Iishi Noboru Hanaoka Koji Higashino Noriya Uedo |
author_sort | Yoji Takeuchi |
collection | DOAJ |
description | Background. Previously, we reported that the Flushknife (electrosurgical endoknife with a water-jet function) could reduce the operation time of colorectal endoscopic submucosal dissection (ESD) however, suitable situation for the Flushknife was obscure. This subgroup analysis of a prospective randomized controlled trial was aimed to investigate the suitable situation for the Flushknife. Methods. A total of 48 superficial colorectal neoplasms that underwent ESD using either the Flexknife or the Flushknife in a referral center were enrolled. The differences of operation time between the Flexknife and the Flushknife groups in each subgroup (tumor size, location, and macroscopic type) were analyzed. Results. Median (95% CI) operation time calculated using survival curves was significantly shorter in the Flushknife group than in the Flexknife group (55.5 min [41, 78] versus 74.0 [57, 90] min; , Hazard Ratio HR: 0.53; 95% CI (0.29–0.97)). In particular, the HR in patients with laterally spreading tumors-nongranular type (LST-NG) in the Flushknife group was significantly smaller than in the Flexknife group (HR: 0.1650.17; 95% CI (0.04–0.66)). There was a trend of decreasing HRs according to larger lesion size. Conclusions. The Flushknife proved its merits in colorectal ESD especially for the lesions which should be removed en bloc (LST-NG and large lesion). |
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institution | Kabale University |
issn | 1687-6121 1687-630X |
language | English |
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spelling | doaj-art-01f7ebd8dff1408bbce4aa19776eab5f2025-02-03T06:01:15ZengWileyGastroenterology Research and Practice1687-61211687-630X2013-01-01201310.1155/2013/530123530123An Electrosurgical Endoknife with a Water-Jet Function (Flushknife) Proves Its Merits in Colorectal Endoscopic Submucosal Dissection Especially for the Cases Which Should Be Removed En BlocYoji Takeuchi0Toshio Shimokawa1Ryu Ishihara2Hiroyasu Iishi3Noboru Hanaoka4Koji Higashino5Noriya Uedo6Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari-ku, Osaka 537-8511, JapanGraduate School of Medicine and Engineering, University of Yamanashi, 4-3-11 Takeda, Kofu City, Yamanashi 400-8511, JapanDepartment of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari-ku, Osaka 537-8511, JapanDepartment of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari-ku, Osaka 537-8511, JapanDepartment of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari-ku, Osaka 537-8511, JapanDepartment of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari-ku, Osaka 537-8511, JapanDepartment of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari-ku, Osaka 537-8511, JapanBackground. Previously, we reported that the Flushknife (electrosurgical endoknife with a water-jet function) could reduce the operation time of colorectal endoscopic submucosal dissection (ESD) however, suitable situation for the Flushknife was obscure. This subgroup analysis of a prospective randomized controlled trial was aimed to investigate the suitable situation for the Flushknife. Methods. A total of 48 superficial colorectal neoplasms that underwent ESD using either the Flexknife or the Flushknife in a referral center were enrolled. The differences of operation time between the Flexknife and the Flushknife groups in each subgroup (tumor size, location, and macroscopic type) were analyzed. Results. Median (95% CI) operation time calculated using survival curves was significantly shorter in the Flushknife group than in the Flexknife group (55.5 min [41, 78] versus 74.0 [57, 90] min; , Hazard Ratio HR: 0.53; 95% CI (0.29–0.97)). In particular, the HR in patients with laterally spreading tumors-nongranular type (LST-NG) in the Flushknife group was significantly smaller than in the Flexknife group (HR: 0.1650.17; 95% CI (0.04–0.66)). There was a trend of decreasing HRs according to larger lesion size. Conclusions. The Flushknife proved its merits in colorectal ESD especially for the lesions which should be removed en bloc (LST-NG and large lesion).http://dx.doi.org/10.1155/2013/530123 |
spellingShingle | Yoji Takeuchi Toshio Shimokawa Ryu Ishihara Hiroyasu Iishi Noboru Hanaoka Koji Higashino Noriya Uedo An Electrosurgical Endoknife with a Water-Jet Function (Flushknife) Proves Its Merits in Colorectal Endoscopic Submucosal Dissection Especially for the Cases Which Should Be Removed En Bloc Gastroenterology Research and Practice |
title | An Electrosurgical Endoknife with a Water-Jet Function (Flushknife) Proves Its Merits in Colorectal Endoscopic Submucosal Dissection Especially for the Cases Which Should Be Removed En Bloc |
title_full | An Electrosurgical Endoknife with a Water-Jet Function (Flushknife) Proves Its Merits in Colorectal Endoscopic Submucosal Dissection Especially for the Cases Which Should Be Removed En Bloc |
title_fullStr | An Electrosurgical Endoknife with a Water-Jet Function (Flushknife) Proves Its Merits in Colorectal Endoscopic Submucosal Dissection Especially for the Cases Which Should Be Removed En Bloc |
title_full_unstemmed | An Electrosurgical Endoknife with a Water-Jet Function (Flushknife) Proves Its Merits in Colorectal Endoscopic Submucosal Dissection Especially for the Cases Which Should Be Removed En Bloc |
title_short | An Electrosurgical Endoknife with a Water-Jet Function (Flushknife) Proves Its Merits in Colorectal Endoscopic Submucosal Dissection Especially for the Cases Which Should Be Removed En Bloc |
title_sort | electrosurgical endoknife with a water jet function flushknife proves its merits in colorectal endoscopic submucosal dissection especially for the cases which should be removed en bloc |
url | http://dx.doi.org/10.1155/2013/530123 |
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