The Efficacy of an Endoscopic Grasp-and-Traction Device for Gastric Endoscopic Submucosal Dissection: An Ex Vivo Comparative Study (with Video)
Clinical Endoscopy
;
: 221-227, 2015.
Article
in English
| WPRIM
| ID: wpr-142428
ABSTRACT
BACKGROUND/AIMS:
To investigate whether the EndoLifter (Olympus), a counter-traction device facilitating submucosal dissection, can accelerate endoscopic submucosal dissection (ESD).METHODS:
Two endoscopists (novice/expert in ESD) performed 64 ESDs (artificial 3-cm lesions) in 16 ex vivo pig stomachs per stomach, two at the posterior wall (forward approach) and two at the lesser curvature (retroflex approach). Per approach, one lesion was dissected with (EL+) and one without (EL-) the EndoLifter. The submucosal dissection time (SDT), corrected for specimen size, and the influence of ESD experience on EndoLifter usefulness were assessed.RESULTS:
En bloc resection rate was 98.4%. In the forward approach, the median SDT was shorter with the EndoLifter (0.56 min/cm2 vs. 0.91 min/cm2), although not significantly (p=0.09). The ESD-experienced endoscopist benefitted more from the EndoLifter (0.45 [EL+] min/cm2 vs. 0.68 [EL-] min/cm2, p=0.07) than the ESD-inexperienced endoscopist (0.77 [EL+] min/cm2 vs. 1.01 [EL-] min/cm2, p=0.48). In the retroflex approach, the median SDTs were 1.06 (EL+) and 0.48 (EL-) min/cm2 (p=0.16). The EndoLifter did not shorten the SDT for the ESD-experienced endoscopist (0.68 [EL+] min/cm2 vs. 0.68 [EL-] min/cm2, p=0.78), whereas the ESD-inexperienced endoscopist seemed hindered (1.65 [EL+] min/cm2 vs. 0.38 [EL-] min/cm2, p=0.03).CONCLUSIONS:
In gastric ESD, the EndoLifter, in trend, shortens SDTs in the forward, but not in the retroflex approach. Given the low numbers in this study, a type II error cannot be excluded.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Stomach
/
Stomach Neoplasms
/
Swine
/
Gastric Mucosa
Language:
English
Journal:
Clinical Endoscopy
Year:
2015
Type:
Article
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