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A Water-Jet Videoendoscope May Reduce Operation Time of Endoscopic Submucosal Dissection for Early Gastric Cancer

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Abstract

Background

One of the problems with endoscopic submucosal dissection (ESD) for early gastric cancer is that it prolongs procedure time considerably.

Aim

The purpose of this study was to investigate whether a videoendoscope with water-jet function shortened the time of ESD for early gastric cancer.

Methods

A total of 82 early gastric cancers that were intramucosal, differentiated-type adenocarcinoma ≤2 cm, without ulcer or scar, in 75 consecutive patients were investigated. Three supervised resident endoscopists participated as operators. After stratification by the operator and tumor location, the lesions were randomly assigned to the water-jet videoendoscope or a conventional videoendoscope groups. An insulated tipped knife was used for the ESD procedure. Total operation time was evaluated as a primary endpoint.

Results

The median (25–75th percentile) total operation time for the water-jet videoendoscope group was 51 (33–87) minutes, which was shorter than the 62 (43–88) minutes for the conventional videoendoscope, but it did not reach significance (P = 0.201). Multivariate analysis revealed that the water-jet videoendoscope (OR 3.0, P = 0.046), tumor size ≤14 mm (OR 3.2, P = 0.040) and antral tumor (OR 4.5, P = 0.046) were significantly associated with short (≤60 min) operation time.

Conclusions

The water-jet videoendoscope may reduce operation time of ESD for early gastric cancer, compared with conventional videoendoscope. A large-scale multicenter trial is warranted to clarify the efficacy of the water-jet videoendoscope for gastric ESD.

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Conflict of interest

None of the authors received funding or have any competing interests to disclose.

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Authors and Affiliations

  1. Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan

    Koichi Tatsumi, Noriya Uedo, Ryu Ishihara, Sachiko Yamamoto, Shunsuke Yamamoto, Eriko Masuda, Motohiko Kato, Yoji Takeuchi, Koji Higashino, Hiroyasu Iishi & Masaharu Tatsuta

  2. Endoscopic Learning and Training Center, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan

    Noriya Uedo & Masaharu Tatsuta

  3. Department of Gastroenterology, Dongo Hospital, Yamatotakada, Nara, Japan

    Koichi Tatsumi

  4. Department of Surgery and Clinical Oncology, Graduate School of Medicine, Osaka University, Osaka, Japan

    Yukinori Kurokawa

  5. Department of Gastrointestinal Oncology, Endoscopic Training and Learning Center, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari-ku, Osaka, 537-8511, Japan

    Noriya Uedo

Authors
  1. Koichi Tatsumi
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  2. Noriya Uedo
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  3. Ryu Ishihara
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  4. Sachiko Yamamoto
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  5. Shunsuke Yamamoto
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  6. Eriko Masuda
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  7. Motohiko Kato
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  8. Yoji Takeuchi
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  9. Koji Higashino
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  10. Hiroyasu Iishi
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  11. Yukinori Kurokawa
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  12. Masaharu Tatsuta
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Corresponding author

Correspondence to Noriya Uedo.

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Tatsumi, K., Uedo, N., Ishihara, R. et al. A Water-Jet Videoendoscope May Reduce Operation Time of Endoscopic Submucosal Dissection for Early Gastric Cancer. Dig Dis Sci 57, 2122–2129 (2012). https://doi.org/10.1007/s10620-012-2138-z

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  • DOI: https://doi.org/10.1007/s10620-012-2138-z

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