Colorectal endoscopic submucosal dissection can be efficiently performed by a trainee with use of a simple traction device and expert supervision
Background and study aims Colorectal endoscopic submucosal dissection (ESD) is technically challenging owing to submucosal fibrosis and difficult endoscope manipulation. Therefore, various traction methods have been reported. We often use a simple looped nylon thread attached to a clip to assist wit...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Georg Thieme Verlag KG
2019-06-01
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| Series: | Endoscopy International Open |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/a-0901-7113 |
| _version_ | 1818434447733686272 |
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| author | Daisuke Ide Shoichi Saito Tomohiko Richard Ohya Yuske Nishikawa Yoshimasa Horie Chihiro Yasue Akiko Chino Masahiro Igarashi Masayuki Saruta Junko Fujisaki |
| author_facet | Daisuke Ide Shoichi Saito Tomohiko Richard Ohya Yuske Nishikawa Yoshimasa Horie Chihiro Yasue Akiko Chino Masahiro Igarashi Masayuki Saruta Junko Fujisaki |
| author_sort | Daisuke Ide |
| collection | DOAJ |
| description | Background and study aims Colorectal endoscopic submucosal dissection (ESD) is technically challenging owing to submucosal fibrosis and difficult endoscope manipulation. Therefore, various traction methods have been reported. We often use a simple looped nylon thread attached to a clip to assist with dissection. We assessed the feasibility of mentor-guided colorectal ESD using this traction device (TD).
Patients and methods From December 2017 to March 2018, we retrospectively reviewed outcomes of 101 colorectal ESDs performed by two groups of endoscopists (A, 5 endoscopists with colorectal ESD experience of < 50 cases; B, 5 endoscopists with experience of > 300 cases). Group A was further divided into two subgroups that performed ESD with or without TD.
Results No significant difference was observed in ESD completion rates (86.1 % [62/72] vs. 96.6 % [28/29]; odds ratio [OR], 0.22; 95 % confidence interval [CI], 0.005 – 1.71; P = 0.17) or procedure times (52.0 min vs. 40.0 min; P = 0.27) and adverse event rates between groups A and B. The rate of TD use was significantly higher in group A than in group B (44.4 % [32/72] vs. 20.7 % [6/29]; OR, 3.03; CI, 1.04 – 10.23; P = 0.03). The completion rate was not different between the two subgroups of group A (with vs. without TD) (81.2 % [26/32] vs. 90.0 % [36/40]; OR, 0.49; CI, 0.09 – 2.29; P = 0.32); however, the proportion of fibrosis cases was significantly higher in the TD-use group (46.8 % [15/32] vs. 22.5 % [9/40]; OR, 2.99; CI, 0.98 – 9.59; P = 0.03).
Conclusion Mentor-guided colorectal ESD using TD was performed efficiently, safely, and in a manner comparable to that of experts. |
| first_indexed | 2024-12-14T16:37:08Z |
| format | Article |
| id | doaj.art-df9862d94a0342bb8dcba4f3ec066721 |
| institution | Directory Open Access Journal |
| issn | 2364-3722 2196-9736 |
| language | English |
| last_indexed | 2024-12-14T16:37:08Z |
| publishDate | 2019-06-01 |
| publisher | Georg Thieme Verlag KG |
| record_format | Article |
| series | Endoscopy International Open |
| spelling | doaj.art-df9862d94a0342bb8dcba4f3ec0667212022-12-21T22:54:25ZengGeorg Thieme Verlag KGEndoscopy International Open2364-37222196-97362019-06-010706E824E83210.1055/a-0901-7113Colorectal endoscopic submucosal dissection can be efficiently performed by a trainee with use of a simple traction device and expert supervisionDaisuke Ide0Shoichi Saito1Tomohiko Richard Ohya2Yuske Nishikawa3Yoshimasa Horie4Chihiro Yasue5Akiko Chino6Masahiro Igarashi7Masayuki Saruta8Junko Fujisaki9Department of Lower Gastrointestinal Medicine, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, JapanDepartment of Lower Gastrointestinal Medicine, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, JapanDepartment of Endoscopy, The Jikei University School of Medicine, Tokyo, JapanDepartment of Lower Gastrointestinal Medicine, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, JapanDepartment of Lower Gastrointestinal Medicine, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, JapanDepartment of Lower Gastrointestinal Medicine, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, JapanDepartment of Lower Gastrointestinal Medicine, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, JapanDepartment of Lower Gastrointestinal Medicine, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, JapanDepartment of Internal Medicine, Division of Gastroenterology and Hepatology, The Jikei University School of Medicine, Tokyo, JapanDepartment of Upper Gastrointestinal Medicine, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, JapanBackground and study aims Colorectal endoscopic submucosal dissection (ESD) is technically challenging owing to submucosal fibrosis and difficult endoscope manipulation. Therefore, various traction methods have been reported. We often use a simple looped nylon thread attached to a clip to assist with dissection. We assessed the feasibility of mentor-guided colorectal ESD using this traction device (TD). Patients and methods From December 2017 to March 2018, we retrospectively reviewed outcomes of 101 colorectal ESDs performed by two groups of endoscopists (A, 5 endoscopists with colorectal ESD experience of < 50 cases; B, 5 endoscopists with experience of > 300 cases). Group A was further divided into two subgroups that performed ESD with or without TD. Results No significant difference was observed in ESD completion rates (86.1 % [62/72] vs. 96.6 % [28/29]; odds ratio [OR], 0.22; 95 % confidence interval [CI], 0.005 – 1.71; P = 0.17) or procedure times (52.0 min vs. 40.0 min; P = 0.27) and adverse event rates between groups A and B. The rate of TD use was significantly higher in group A than in group B (44.4 % [32/72] vs. 20.7 % [6/29]; OR, 3.03; CI, 1.04 – 10.23; P = 0.03). The completion rate was not different between the two subgroups of group A (with vs. without TD) (81.2 % [26/32] vs. 90.0 % [36/40]; OR, 0.49; CI, 0.09 – 2.29; P = 0.32); however, the proportion of fibrosis cases was significantly higher in the TD-use group (46.8 % [15/32] vs. 22.5 % [9/40]; OR, 2.99; CI, 0.98 – 9.59; P = 0.03). Conclusion Mentor-guided colorectal ESD using TD was performed efficiently, safely, and in a manner comparable to that of experts.http://www.thieme-connect.de/DOI/DOI?10.1055/a-0901-7113 |
| spellingShingle | Daisuke Ide Shoichi Saito Tomohiko Richard Ohya Yuske Nishikawa Yoshimasa Horie Chihiro Yasue Akiko Chino Masahiro Igarashi Masayuki Saruta Junko Fujisaki Colorectal endoscopic submucosal dissection can be efficiently performed by a trainee with use of a simple traction device and expert supervision Endoscopy International Open |
| title | Colorectal endoscopic submucosal dissection can be efficiently performed by a trainee with use of a simple traction device and expert supervision |
| title_full | Colorectal endoscopic submucosal dissection can be efficiently performed by a trainee with use of a simple traction device and expert supervision |
| title_fullStr | Colorectal endoscopic submucosal dissection can be efficiently performed by a trainee with use of a simple traction device and expert supervision |
| title_full_unstemmed | Colorectal endoscopic submucosal dissection can be efficiently performed by a trainee with use of a simple traction device and expert supervision |
| title_short | Colorectal endoscopic submucosal dissection can be efficiently performed by a trainee with use of a simple traction device and expert supervision |
| title_sort | colorectal endoscopic submucosal dissection can be efficiently performed by a trainee with use of a simple traction device and expert supervision |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/a-0901-7113 |
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