Traction with using a Rubber Band and Clips for Effective Endoscopic Submucosal Dissection / 대한소화기내시경학회지

ABSTRACT

BACKGROUND/AIMS: Traction with using a rubber band and clips may be helpful for performing endoscopic submucosal dissection (ESD) by keeping adequate tissue tension and satisfactory submucosal exposure. METHODS: 17 patients with noninvasive neoplasias or intramucosal cancers (16 gastric lesions and 1 colonic lesion) were included to evaluate this technique's feasibility (3), because of a difficult location for dissection (11), unsatisfactory mucosal elevation despite adequate submucosal injection (2), and a high risk of perforation from the thin colonic wall (1). Submucosal dissection was performed after traction was applied, with a using a rubber band and clips, to a precut margin of the lesion. RESULTS: The mean sizes of the 16 gastric neoplasias and the corresponding resected specimens were 16+/-9 mm (6~40) and 37+/-9 mm (18~50), respectively, and the sizes of the colonic intramucosal cancers and the resected specimens were 41 mm and 51 mm), respectively. Both the en-bloc resection rate and the complete resection rate were 77%. Complete ESD without snaring was preformed in 10 cases (59%). The traction was assessed as useful in eleven cases (65%), not useful in two (12%), and annoying in four (23%). CONCLUSIONS: Traction with using a rubber band and clips can be useful for performing ESD.