Effects of the combined use of a scissor-type knife and traction clip on endoscopic submucosal dissection of colorectal tumors: a propensity score-matched analysis
Background and study aims This study evaluated the technical aspects of colorectal endoscopic submucosal dissection (ESD) with the Clutch Cutter (CC) (Fujifilm Co., Tokyo, Japan), a scissor-type knife, and the S-O clip (SO) as a traction clip, and compared the safety and efficacy to ESD using a need...
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Georg Thieme Verlag KG
2021
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oai:doaj.org-article:73b5625da779496f94865e601f5846032021-11-13T00:00:31ZEffects of the combined use of a scissor-type knife and traction clip on endoscopic submucosal dissection of colorectal tumors: a propensity score-matched analysis2364-37222196-973610.1055/a-1535-0786https://doaj.org/article/73b5625da779496f94865e601f5846032021-11-01T00:00:00Zhttp://www.thieme-connect.de/DOI/DOI?10.1055/a-1535-0786https://doaj.org/toc/2364-3722https://doaj.org/toc/2196-9736Background and study aims This study evaluated the technical aspects of colorectal endoscopic submucosal dissection (ESD) with the Clutch Cutter (CC) (Fujifilm Co., Tokyo, Japan), a scissor-type knife, and the S-O clip (SO) as a traction clip, and compared the safety and efficacy to ESD using a needle-type knife. Patients and methods This was a single-center retrospective study. In Study 1, we evaluated 125 ESD patients: 60 using the SO and CC (SO group) and 65 using the CC (CC group). In Study 2, we evaluated 185 ESD patients: the CC group (N = 65) and 120 using the Flush knife BT-S (Flush group) (Fujifilm Co., Tokyo, Japan). In both studies, the clinicopathological features and therapeutic outcomes were compared using a propensity score-matched analysis. Results In 36 pairs of matched patients in Study 1, the rates of en bloc resection, R0 resection, perforation, and postoperative bleeding (POB) were 97.2 %, 88.9 %, 2.8 %, and 0 %, respectively, for the SO group and 100 %, 91.7 %, 0 %, and 0 % for the CC group (not significant). The mean procedure time for the SO group among less-experienced endoscopists was significantly shorter than in the CC group (42 vs. 65 minutes, P = 0.036). In 49 pairs of matched patients in Study 2, the rates of en bloc resection, R0 resection, perforation, and POB were 100 %, 95.8 %, 0 %, and 0 %, respectively, for the CC group and 98.0 %, 95.8 %, 0 %, and 2.0 % for the Flush group (not significant). The mean procedure time in the CC group among less-experienced endoscopists was significantly shorter than in the Flush group (52 vs. 67 minutes, P = 0.038). Conclusions CC and the combined use of CC and SO reduced colorectal ESD procedure time among less-experienced endoscopists.Ken InoueNaohisa YoshidaOsamu DohiSatoshi SuginoShinya MatsumuraHiroaki KitaeRitsu YasudaTakahiro NakanoKei TerasakiRyohei HiroseYuji NaitoTakaaki MurakamiYutaka InadaKiyoshi OgisoYukiko MorinagaMitsuo KishimotoItoh YoshitoGeorg Thieme Verlag KGarticleDiseases of the digestive system. GastroenterologyRC799-869ENEndoscopy International Open, Vol 09, Iss 11, Pp E1617-E1626 (2021) |
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Diseases of the digestive system. Gastroenterology RC799-869 |
| spellingShingle |
Diseases of the digestive system. Gastroenterology RC799-869 Ken Inoue Naohisa Yoshida Osamu Dohi Satoshi Sugino Shinya Matsumura Hiroaki Kitae Ritsu Yasuda Takahiro Nakano Kei Terasaki Ryohei Hirose Yuji Naito Takaaki Murakami Yutaka Inada Kiyoshi Ogiso Yukiko Morinaga Mitsuo Kishimoto Itoh Yoshito Effects of the combined use of a scissor-type knife and traction clip on endoscopic submucosal dissection of colorectal tumors: a propensity score-matched analysis |
| description |
Background and study aims This study evaluated the technical aspects of colorectal endoscopic submucosal dissection (ESD) with the Clutch Cutter (CC) (Fujifilm Co., Tokyo, Japan), a scissor-type knife, and the S-O clip (SO) as a traction clip, and compared the safety and efficacy to ESD using a needle-type knife.
Patients and methods This was a single-center retrospective study. In Study 1, we evaluated 125 ESD patients: 60 using the SO and CC (SO group) and 65 using the CC (CC group). In Study 2, we evaluated 185 ESD patients: the CC group (N = 65) and 120 using the Flush knife BT-S (Flush group) (Fujifilm Co., Tokyo, Japan). In both studies, the clinicopathological features and therapeutic outcomes were compared using a propensity score-matched analysis.
Results In 36 pairs of matched patients in Study 1, the rates of en bloc resection, R0 resection, perforation, and postoperative bleeding (POB) were 97.2 %, 88.9 %, 2.8 %, and 0 %, respectively, for the SO group and 100 %, 91.7 %, 0 %, and 0 % for the CC group (not significant). The mean procedure time for the SO group among less-experienced endoscopists was significantly shorter than in the CC group (42 vs. 65 minutes, P = 0.036). In 49 pairs of matched patients in Study 2, the rates of en bloc resection, R0 resection, perforation, and POB were 100 %, 95.8 %, 0 %, and 0 %, respectively, for the CC group and 98.0 %, 95.8 %, 0 %, and 2.0 % for the Flush group (not significant). The mean procedure time in the CC group among less-experienced endoscopists was significantly shorter than in the Flush group (52 vs. 67 minutes, P = 0.038).
Conclusions CC and the combined use of CC and SO reduced colorectal ESD procedure time among less-experienced endoscopists. |
| format |
article |
| author |
Ken Inoue Naohisa Yoshida Osamu Dohi Satoshi Sugino Shinya Matsumura Hiroaki Kitae Ritsu Yasuda Takahiro Nakano Kei Terasaki Ryohei Hirose Yuji Naito Takaaki Murakami Yutaka Inada Kiyoshi Ogiso Yukiko Morinaga Mitsuo Kishimoto Itoh Yoshito |
| author_facet |
Ken Inoue Naohisa Yoshida Osamu Dohi Satoshi Sugino Shinya Matsumura Hiroaki Kitae Ritsu Yasuda Takahiro Nakano Kei Terasaki Ryohei Hirose Yuji Naito Takaaki Murakami Yutaka Inada Kiyoshi Ogiso Yukiko Morinaga Mitsuo Kishimoto Itoh Yoshito |
| author_sort |
Ken Inoue |
| title |
Effects of the combined use of a scissor-type knife and traction clip on endoscopic submucosal dissection of colorectal tumors: a propensity score-matched analysis |
| title_short |
Effects of the combined use of a scissor-type knife and traction clip on endoscopic submucosal dissection of colorectal tumors: a propensity score-matched analysis |
| title_full |
Effects of the combined use of a scissor-type knife and traction clip on endoscopic submucosal dissection of colorectal tumors: a propensity score-matched analysis |
| title_fullStr |
Effects of the combined use of a scissor-type knife and traction clip on endoscopic submucosal dissection of colorectal tumors: a propensity score-matched analysis |
| title_full_unstemmed |
Effects of the combined use of a scissor-type knife and traction clip on endoscopic submucosal dissection of colorectal tumors: a propensity score-matched analysis |
| title_sort |
effects of the combined use of a scissor-type knife and traction clip on endoscopic submucosal dissection of colorectal tumors: a propensity score-matched analysis |
| publisher |
Georg Thieme Verlag KG |
| publishDate |
2021 |
| url |
https://doaj.org/article/73b5625da779496f94865e601f584603 |
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