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Application of in vivo traction-assisted resection of proximal colon lesions: a case series (with video)

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Abstract

Background

Endoscopic submucosal dissection (ESD) is the treatment of choice for colorectal neoplasms in Japan. ESD can completely peel off the lesion and is associated with a significantly lower recurrence rate of colorectal cancers than EMR and is widely used to treat gastrointestinal tumors. This study aimed to evaluate in vivo traction in endoscopic submucosal dissection (ESD) of proximal colon lesions.

Methods

This retrospective study included patients with lesions in the proximal colon who received ESD treatment at Qilu Hospital of Shandong University from June 2018 to December 2020. Patients were divided into two groups according to the in vivo traction method (orthodontic ring or elastic ring) during operation. The operation time, dissection time, proportion of complete resection of lesions, and complications were compared between the two groups.

Results

There were 28 patients in this study. In the orthodontic ring group (n = 10), the average lesion diameter was 2.0–2.5 cm, and the average operation and dissection times were 26.5 ± 7.47 and 21.5 ± 7.47 min, respectively. In the elastic ring group (n = 18), the average lesion diameter was 2.5–5.5 cm, and the average operation and dissection times were 27.39 ± 11.83 and 22.39 ± 11.83 min, respectively. All lesions were completely resected in a single operation, and no wound perforation and delayed bleeding occurred.

Conclusion

In vivo traction-assisted ESD can be used to resect proximal colon lesions in selected patients (precancerous lesions and early colon cancer limited to the mucosa or with a submucosa infiltration depth of < 1000 µm).

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Acknowledgements

None.

Funding

This study was supported by Qingdao Municipal Medical Research Guidance Plan in 2019 (Grant No.2019-WJZD161).

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Author notes

  1. Aijun Zhang, Yanjun Song have contributed equally to this work.

Authors and Affiliations

  1. Department of Gastroenterology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China

    Aijun Zhang, Yanjun Song, Xiangdan Cui, Baihui Wang & Ruyuan Li

Authors
  1. Aijun Zhang
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  2. Yanjun Song
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  3. Xiangdan Cui
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  4. Baihui Wang
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  5. Ruyuan Li
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Corresponding author

Correspondence to Ruyuan Li.

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Disclosures

Aijun Zhang, Yanjun Song, Xiangdan Cui, Baihui Wang, and Ruyuan Li have no conflict of interest to disclose.

Ethical approval

This study was approved by the Ethics Committee of Qilu Hospital of Shandong University [No: KYLL-2020043], and the need for informed consent was waived by the review board due to the retrospective nature of this study.

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Supplementary Information

Below is the link to the electronic supplementary material.

464_2022_9266_MOESM1_ESM.docx

Supplementary file1 Figure S1. The traction orthodontic ring. The large hole has a diameter of 8 mm. The small hole has a diameter of 2 mm (DOCX 2519 kb)

Supplementary file2 Video 1 In vivo traction-assisted resection of a proximal colon lesion (MP4 400489 kb)

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Zhang, A., Song, Y., Cui, X. et al. Application of in vivo traction-assisted resection of proximal colon lesions: a case series (with video). Surg Endosc 36, 8231–8236 (2022). https://doi.org/10.1007/s00464-022-09266-y

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  • DOI: https://doi.org/10.1007/s00464-022-09266-y

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