Advertisement

Safety and efficacy of endoscopic submucosal dissection using IT knife nano with clip traction method for early esophageal squamous cell carcinoma

  • 353 Accesses

  • 3 Citations

Abstract

Background

Although endoscopic submucosal dissection (ESD) is an accepted and established treatment for early esophageal squamous cell carcinoma (EESCC), it is technically difficult, time consuming, and less safe than endoscopic mucosal resection. To perform ESD safely and more efficiently, we proposed a new technique of esophageal ESD using an IT knife nano with the clip traction method. This study aimed to evaluate the efficacy and safety of ESD using this new technique.

Methods

We retrospectively reviewed all consecutive cases of esophageal ESD performed using an IT knife nano with the clip traction method at our hospital between March 2013 and January 2017. Therapeutic efficacy and safety were also assessed.

Results

A total of 103 patients underwent esophageal ESD using the IT knife nano with the clip traction method. In all cases, we performed en bloc resection. Complete resection was achieved in 100 cases (97.1%). The median operating time was 40 (range 13–230) min. No cases of perforation or delayed bleeding occurred. Although two cases (2.0%) of mediastinal emphysema occurred without visible perforation at endoscopy, all were successfully managed conservatively.

Conclusions

The new technique of esophageal ESD using the IT knife nano with the clip traction method appears to be feasible, effective, and safe for EESCC treatment.

This is a preview of subscription content, log in to check access.

Access options

Buy single article

Instant unlimited access to the full article PDF.

US$ 39.95

Price includes VAT for USA

Fig. 1
Fig. 2
Fig. 3

References

  1. 1.

    Nagami Y, Tominaga K, Machida H et al (2014) Usefulness of non-magnifying narrow-band imaging in screening of early esophageal squamous cell carcinoma: a prospective comparative study using propensity score matching. Am J Gastroenterol 109(6):845–854

  2. 2.

    Katada C, Muto M, Momma K et al (2007) Clinical outcome after endoscopic mucosal resection for esophageal squamous cell carcinoma invading the muscularis mucosae-a multicenter retrospective cohort study. Endoscopy 39(9):779–783

  3. 3.

    Ishihara R, Iishi H, Uedo N et al (2008) Comparison of EMR and endoscopic submucosal dissection for en bloc resection of early esophageal cancers in Japan. Gastrointest Endosc 68(6):1066–1072

  4. 4.

    Takahashi H, Arimura Y, Masao H et al (2010) Endoscopic submucosal dissection is superior to conventional endoscopic resection as a curative treatment for early squamous cell carcinoma of the esophagus (with video). Gastrointest Endosc 72(2):255–264

  5. 5.

    Cao Y, Liao C, Tan A et al (2009) Meta-analysis of endoscopic submucosal dissection versus endoscopic mucosal resection for tumors of the gastrointestinal tract. Endoscopy 41:751–757

  6. 6.

    Oyama T (2012) Counter traction makes endoscopic submucosal dissection easier. Clin Endosc 45:375–378

  7. 7.

    Jeon WJ, You IY, Chae HB et al (2009) A new technique for gastric endoscopic submucosal dissection: peroral traction-assisted endoscopic submucosal dissection. Gastrointest Endosc 69:29–33

  8. 8.

    Suzuki S, Gotoda T, Kobayashi Y et al (2016) Usefulness of a traction method using dental floss and a hemoclip for gastric endoscopic submucosal dissection: a propensity score matching analysis (with videos). Gastrointest Endosc 83:337–346

  9. 9.

    Yamasaki Y, Takeuchi Y, Uedo N et al (2016) Traction-assisted colonic endoscopic submucosal dissection using clip and line: a feasibility study. Endosc Int Open 4:E51–E55

  10. 10.

    Ota M, Nakamura T, Hayashi K et al (2012) Usefulness of clip traction in the early phase of esophageal endoscopic submucosal dissection. Dig Endosc 24:315–318

  11. 11.

    Koike Y, Hirasawa D, Fujita N et al (2015) Usefulness of the thread-traction method in esophageal endoscopic submucosal dissection: randomized controlled trial. Dig Endosc 27:303–309

  12. 12.

    Suzuki T, Hara T, Kitagawa Y et al (2016) Usefulness of IT knife nano for endoscopic submucosal dissection of large colo-rectal lesions. Acta Gastroenterol Belg 79:186–190

  13. 13.

    Ono H, Kondo H, Yoshida S et al (2001) Endoscopic mucosal resection for treatment of early gastric cancer. Gut 48:151–152

  14. 14.

    Ono H, Hasuike N, Inui T et al (2008) Usefulness of a novel electrosurgical knife, the insulation-tipped diathermic knife-2, for endoscopic submucosal dissection of early gastric cancer. Gastric Cancer 11:47–52

  15. 15.

    Shimizu Y, Takahashi M, Yoshida T et al (2013) Endoscopic resection (endoscopic mucosal resection/endoscopic submucosal dissection) for superficial esophageal squamous cell carcinoma: current status of various techniques. Dig Endosc 25:13–19

  16. 16.

    Pioche M, Mais L, Guillaud O et al (2013) Endoscopic submucosal tunnel dissection for large esophageal neoplastic lesions. Endoscopy 45:1032–1034

  17. 17.

    Linghu E, Feng X, Wang X et al (2013) Endoscopic submucosal tunnel dissection for large esophageal neoplastic lesions. Endoscopy 45:60–62

  18. 18.

    Akahoshi K, Minoda Y, Komori K et al (2013) Endoscopic submucosal dissection using the “Clutch Cutter” for early esophageal squamous cell carcinoma. Endoscopy 45:1035–1038

  19. 19.

    Fujishiro M, Yahagi N, Kakushima N et al (2006) Endoscopic submucosal dissection of esophageal squamous cell neoplasms. Clin Gastroenterol Hepatol 4:688–694

  20. 20.

    Lee CT, Chang CY, Tai CM et al (2012) Endoscopic submucosal dissection for early esophageal neoplasia: a single center experience in Taiwan. J Formosan Med Assoc 111:132–139

  21. 21.

    Maeda Y, Hirasawa D, Fujita N et al (2011) Mediastinal emphysema after esophageal endoscopic submucosal dissection: its prevalence and clinical significance. Dig Endosc 23:221–226

  22. 22.

    Maeda Y, Hirasawa D, Fujita N et al (2012) A pilot study to assess mediastinal emphysema after esophageal endoscopic submucosal dissection with carbon dioxide insufflation. Endoscopy 44:565–571

  23. 23.

    Repici A, Hassan C, Carlino A et al (2010) Endoscopic submucosal dissection in patients with early esophageal squamous cell carcinoma: results from a prospective Western series. Gastrointest Endosc 71:715–721

  24. 24.

    Yoo JH, Shin SJ, Lee KM et al (2012) Risk factors for perforations associated with endoscopic submucosal dissection in gastric lesions: emphasis on perforation type. Surg Endosc 26:2456–2464

  25. 25.

    Watari J, Tomita T, Toyoshima F et al (2013) Clinical outcomes and risk factors for perforation in gastric endoscopic submucosal dissection: a prospective pilot study. World J Gastrointest Endosc 5:281–287

Download references

Author information

Correspondence to Yoshiyasu Kitagawa.

Ethics declarations

Disclosures

Yoshiyasu Kitagawa, Takuto Suzuki, Taro Hara, Taketo Yamaguchi have no conflicts of interest or financial ties to disclose.

Electronic supplementary material

Supplementary material 1 (MOV 88796 kb)

Supplementary material 1 (MOV 88796 kb)

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Kitagawa, Y., Suzuki, T., Hara, T. et al. Safety and efficacy of endoscopic submucosal dissection using IT knife nano with clip traction method for early esophageal squamous cell carcinoma. Surg Endosc 32, 450–455 (2018) doi:10.1007/s00464-017-5703-x

Download citation

Keywords

  • Endoscopic submucosal dissection
  • Early esophageal squamous cell carcinoma
  • IT knife nano
  • Clip traction method