Esophageal Endoscopic Submucosal Dissection Assisted by an Overtube with a Traction Forceps: An Animal Study
Esophageal endoscopic submucosal dissection (ESD) is technically difficult. To make it safer, we developed a novel method using overtube with a traction forceps (OTF) for countertraction during submucosal dissection. We conducted an ex vivo animal study and compared the clinical outcomes between OTF...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2016/3186168 |
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| author | Ken Ohata Kuangi Fu Eiji Sakai Kouichi Nonaka Tomoaki Tashima Yohei Minato Akiko Ohno Takafumi Ito Yosuke Tsuji Hideyuki Chiba Makoto Yamawaki Hideyuki Hemmi Teruo Nakaya Junichi Fukushima Nobuyuki Matsuhashi |
| author_facet | Ken Ohata Kuangi Fu Eiji Sakai Kouichi Nonaka Tomoaki Tashima Yohei Minato Akiko Ohno Takafumi Ito Yosuke Tsuji Hideyuki Chiba Makoto Yamawaki Hideyuki Hemmi Teruo Nakaya Junichi Fukushima Nobuyuki Matsuhashi |
| author_sort | Ken Ohata |
| collection | DOAJ |
| description | Esophageal endoscopic submucosal dissection (ESD) is technically difficult. To make it safer, we developed a novel method using overtube with a traction forceps (OTF) for countertraction during submucosal dissection. We conducted an ex vivo animal study and compared the clinical outcomes between OTF-ESD and conventional method (C-ESD). A total of 32 esophageal ESD procedures were performed by four beginner and expert endoscopists. After circumferential mucosal incision for the target lesion, structured as the isolated pig esophagus 3 cm long, either C-ESD or OTF-ESD was randomly selected for submucosal dissection. All the ESD procedures were completed as en bloc resections, while perforation only occurred in a beginner’s C-ESD procedure. The dissection time for OTF-ESD was significantly shorter than that for C-ESD for both the beginner and expert endoscopists (22.8±8.3 min versus 7.8±4.5 min, P<0.001, and 11.3±4.4 min versus 5.9±2.5 min, P=0.01, resp.). The frequency and volume of the submucosal injections were significantly smaller for OTF-ESD than for C-ESD (1.3±0.6 times versus 2.9±1.5 times, P<0.001, and 5.3±2.8 mL versus 15.6±7.3 mL, P<0.001, resp.). Histologically, muscular injury was more common among the C-ESD procedures (80% versus 13%, P=0.009). Our results indicated that the OTF-ESD technique is useful for the safe and easy completion of esophageal ESD. |
| format | Article |
| id | doaj-art-2668e9f0339a4fce876be1d43002de57 |
| institution | Kabale University |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Gastroenterology Research and Practice |
| spelling | doaj-art-2668e9f0339a4fce876be1d43002de572025-02-03T07:24:06ZengWileyGastroenterology Research and Practice1687-61211687-630X2016-01-01201610.1155/2016/31861683186168Esophageal Endoscopic Submucosal Dissection Assisted by an Overtube with a Traction Forceps: An Animal StudyKen Ohata0Kuangi Fu1Eiji Sakai2Kouichi Nonaka3Tomoaki Tashima4Yohei Minato5Akiko Ohno6Takafumi Ito7Yosuke Tsuji8Hideyuki Chiba9Makoto Yamawaki10Hideyuki Hemmi11Teruo Nakaya12Junichi Fukushima13Nobuyuki Matsuhashi14Department of Gastroenterology, NTT Medical Center Tokyo, Tokyo 141-8625, JapanDepartment of Endoscopy, Kanma Memorial Hospital, Nasushiobara 325-0046, JapanDepartment of Gastroenterology, NTT Medical Center Tokyo, Tokyo 141-8625, JapanDepartment of Gastroenterology, NTT Medical Center Tokyo, Tokyo 141-8625, JapanDepartment of Gastroenterology, NTT Medical Center Tokyo, Tokyo 141-8625, JapanDepartment of Gastroenterology, NTT Medical Center Tokyo, Tokyo 141-8625, JapanDepartment of Gastroenterology, Kyorin University School of Medicine, Tokyo 181-8611, JapanDepartment of Gastroenterology, Keiyu Hospital, Yokohama 220-0012, JapanDepartment of Gastroenterology, University of Tokyo, Tokyo 113-8655, JapanDepartment of Gastroenterology, Omori Red Cross Hospital, Tokyo 143-8527, JapanDivision of Gastroenterology, Department of Internal Medicine, Yokkaichi Municipal Hospital, Yokkaichi 510-0822, JapanDepartment of Gastroenterology, Moriguchi Keijinkai Hospital, Osaka 570-0021, JapanDepartment of Gastroenterology, Yamaga Chuo Hospital, Yamaga 861-0501, JapanDepartment of Diagnostic Pathology, NTT Medical Center Tokyo, Tokyo 141-8625, JapanDepartment of Gastroenterology, NTT Medical Center Tokyo, Tokyo 141-8625, JapanEsophageal endoscopic submucosal dissection (ESD) is technically difficult. To make it safer, we developed a novel method using overtube with a traction forceps (OTF) for countertraction during submucosal dissection. We conducted an ex vivo animal study and compared the clinical outcomes between OTF-ESD and conventional method (C-ESD). A total of 32 esophageal ESD procedures were performed by four beginner and expert endoscopists. After circumferential mucosal incision for the target lesion, structured as the isolated pig esophagus 3 cm long, either C-ESD or OTF-ESD was randomly selected for submucosal dissection. All the ESD procedures were completed as en bloc resections, while perforation only occurred in a beginner’s C-ESD procedure. The dissection time for OTF-ESD was significantly shorter than that for C-ESD for both the beginner and expert endoscopists (22.8±8.3 min versus 7.8±4.5 min, P<0.001, and 11.3±4.4 min versus 5.9±2.5 min, P=0.01, resp.). The frequency and volume of the submucosal injections were significantly smaller for OTF-ESD than for C-ESD (1.3±0.6 times versus 2.9±1.5 times, P<0.001, and 5.3±2.8 mL versus 15.6±7.3 mL, P<0.001, resp.). Histologically, muscular injury was more common among the C-ESD procedures (80% versus 13%, P=0.009). Our results indicated that the OTF-ESD technique is useful for the safe and easy completion of esophageal ESD.http://dx.doi.org/10.1155/2016/3186168 |
| spellingShingle | Ken Ohata Kuangi Fu Eiji Sakai Kouichi Nonaka Tomoaki Tashima Yohei Minato Akiko Ohno Takafumi Ito Yosuke Tsuji Hideyuki Chiba Makoto Yamawaki Hideyuki Hemmi Teruo Nakaya Junichi Fukushima Nobuyuki Matsuhashi Esophageal Endoscopic Submucosal Dissection Assisted by an Overtube with a Traction Forceps: An Animal Study Gastroenterology Research and Practice |
| title | Esophageal Endoscopic Submucosal Dissection Assisted by an Overtube with a Traction Forceps: An Animal Study |
| title_full | Esophageal Endoscopic Submucosal Dissection Assisted by an Overtube with a Traction Forceps: An Animal Study |
| title_fullStr | Esophageal Endoscopic Submucosal Dissection Assisted by an Overtube with a Traction Forceps: An Animal Study |
| title_full_unstemmed | Esophageal Endoscopic Submucosal Dissection Assisted by an Overtube with a Traction Forceps: An Animal Study |
| title_short | Esophageal Endoscopic Submucosal Dissection Assisted by an Overtube with a Traction Forceps: An Animal Study |
| title_sort | esophageal endoscopic submucosal dissection assisted by an overtube with a traction forceps an animal study |
| url | http://dx.doi.org/10.1155/2016/3186168 |
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