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GI endoscopic submucosal dissection using a calibrated, small-caliber-tip, transparent hood for lesions with fibrosis.

ABSTRACT: Video 1The video shows the introduction of a calibrated, small-caliber-tip, transparent hood and its use in rectal, gastric, and duodenal endoscopic submucosal dissection with severe fibrosis.

SUBMITTER: Nomura T

PROVIDER: S-EPMC8267961 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Multiband mucosectomy versus endoscopic submucosal dissection and endoscopic submucosal excavation for GI submucosal tumors: short and long term follow-up.

Project description:AIMS:To evaluate the short- and long-term outcomes of 3 different endoscopic dissection techniques for upper gastrointestinal (GI) submucosal tumours (SMTs). METHODS:Data for 135 patients withGI SMTs who underwent multiband mucosectomy (MBM), endoscopic submucosal dissection (ESD), or endoscopic submucosal excavation (ESE) were retrospectively assessed. The en bloc resection rate, endoscopic complete resection rate, operation time, potential complications and local recurrence rate were compared. RESULTS:No significant differences were observed in the rate of endoscopic complete resections and pathologic complete resections among the three groups. For SMTs >?15?mm in width, the lowest en bloc resection rate was found for MBM (P?=?0.000). MBM was also associated with the shortest procedure time, lowest perforation rate and lowest rate of major bleeding. ESE was the most effective procedure for muscularis propria (MP) lesions but was associated with the longest operation time (P?<?0.01). The ESD and ESE groups had similar perforation rates (P?>?0.05). No differences were observed in 4-year local recurrence rates among the groups (P?=?0.945). CONCLUSIONS:MBM is a simple and effective method for the treatment of small SMTs and achieves clinical success rates similar to those of ESD and ESE. However, ESD and ESE are preferable for larger and deep lesions and are associated with a longer operation time. Nonetheless, all 3 techniques resulted in a low 4-year local recurrence rate. Large-scale randomized clinical trials are needed to further investigate these results.

| S-EPMC6731551 | biostudies-literature

Endoscopic submucosal dissection using a new super-soft hood and the multipoint traction technique.

Project description: Not available

| S-EPMC7332761 | biostudies-literature

Getting the gist of GI stromal tumors: diving deeper than endoscopic submucosal dissection.

Project description:Video 1Endoscopic full-thickness resection of a GI stromal tumor lesion arising in the rectum's muscularis propria.

| S-EPMC10251400 | biostudies-literature

Maximizing limited space: usefulness of percutaneous cricothyrotomy and super-soft hood for hypopharyngeal endoscopic submucosal dissection.

Project description:Video 1Demonstration of the usefulness of percutaneous cricothyrotomy and a super-soft hood for hypopharyngeal endoscopic submucosal dissection.

| S-EPMC10577375 | biostudies-literature

Safety and Efficacy of a modified small-caliber-tip transparent hood in endoscopic decompression for obstructive colorectal cancer

Project description:Interventions: Endoscopic decompression using modified ST hood (Replaced with conventional hood only if failure occurs with modified ST hood within a specified time). Endoscopic decompression using conventional hood (Replaced with modified ST hood only if failure occurs with conventional hood within a specified time). Primary outcome(s): Success rate and procedure time to pass the guide-wire through the colorectal stricture site. Study Design: Parallel Randomized

| 2617969 | ecrin-mdr-crc

Short-term outcomes of patients undergoing endoscopic submucosal dissection for colorectal lesions.

Project description:ObjectivesEndoscopic submucosal dissection (ESD) of colorectal lesions was invented in Japan, but postoperative management including hospital stay has not been reconsidered due to the Japanese insurance system. To explore appropriate postoperative management after colorectal ESD, we reviewed short-term outcomes after ESD in non-selected consecutive patients.MethodsPatients who underwent colorectal ESD from April 2013 to September 2020 in one institution were reviewed. The primary outcome measure was the occurrence of adverse events stratified by the Clavien-Dindo classification with five grades. A logistic regression model with the Firth procedure was applied to investigate predictors of severe (grade III or greater) adverse events.ResultsA total of 330 patients (female 40%, male 60%; median 72 years; IQR 65-80 years) with colorectal lesions (median 30 mm, IQR 23-40 mm; colon 77%, rectum 23%; serrated lesion 4%, adenoma 47%, mucosal cancer 30%, invasive cancer 18%) was evaluated. The en bloc resection rate was 97%. The median dissection time was 58 min (IQR: 38-86). Intraprocedural perforation occurred in 3%, all successfully treated by endoscopic clipping. No delayed perforations occurred. Postprocedural bleeding occurred in 3% on days 1-10 (median day 2); all were controlled endoscopically. Severe adverse events included only delayed bleeding. In analyzing severe adverse events in a multivariate logistic regression model with the Firth procedure, antithrombotic agent use (p = 0.016) and rectal lesions (p = 0.0010) were both significant predictors.ConclusionsNo serious adverse events occurred in this series. Four days of hospitalization may be too long for the majority of patients after ESD.

| S-EPMC9307737 | biostudies-literature

Countertraction in endoscopic submucosal dissection.

Project description: Not available

| S-EPMC5989134 | biostudies-literature

Hybrid resection of GI stromal tumor with endoscopic submucosal dissection and the full-thickness resection device.

Project description:Video 1Hybrid resection of gastric GI stromal tumor with endoscopic submucosal dissection and the Full-Thickness Resection Device.

| S-EPMC9832239 | biostudies-literature

Successful esophageal endoscopic submucosal dissection with intraoperative release of stenosis due to previous endoscopic submucosal dissection scarring.

Project description:Endoscopic submucosal dissection (ESD) is the standard endoscopic treatment for early esophageal cancer. Esophageal stricture often occurs at the site of ESD for large lesions. When treating a metachronous lesion appearing at the severe stricture, it may be difficult to negotiate a conventional endoscope through the stricture. Using a thin endoscope may be a useful strategy for such lesions, though ESD using a thin endoscope is challenging because of poor maneuverability. Herein, we report a case of successful ESD for early esophageal cancer at the severe stricture, using a conventional endoscope. A 72-year-old man with a previous history of ESD for esophageal cancer and a post-ESD esophageal stricture was referred to our hospital for metachronous early esophageal cancer. The lesion, 10 mm in diameter, was located at the stricture with a slight distal extension. Conventional endoscopes could not be negotiated through stricture. Therefore, submucosal dissection was performed from the oral to the anal aspect of the lesion, as far as possible. After completion of submucosal dissection of the oral aspect of the lesion and part of the lesion located on the stricture, the severe stricture was released, allowing the passage of conventional endoscope, and ESD of the entire lesion was completed en bloc. Histopathological examination showed squamous cell carcinoma, pT1a-LPM. Stricture due to scarring may occur during the regeneration process of the defective mucosa, muscularis mucosa, and submucosal layer. Therefore, incision and dissection of the contracted mucosa, mucularis mucosa, and submucosal layer would release the stenosis.

| S-EPMC8828227 | biostudies-literature

Comparisons of outcomes between ProKnife injection endoscopic submucosal dissection and conventional endoscopic submucosal dissection for large gastric lesions in ex vivo porcine model study: A randomized controlled trial.

Project description:ObjectiveTo compare treatment outcomes between injection endoscopic submucosal dissection using ProKnife (P-ESD) and conventional ESD (C-ESD) for gastric lesions.MethodsIn this randomized controlled trial, we compared treatment outcomes of P-ESD and C-ESD for simulated gastric lesions ≥3 cm in resected porcine stomachs. Predictive factors associated with ESD difficulties were investigated using logistic regression analysis.ResultsSeventy lesions were screened; however, two lesions were excluded. A total of 12 endoscopists performed 68 ESDs: 34 P-ESDs and 34 C-ESDs. The ESD procedure time of P-ESD (36.3 [28.4-46.8] min) was significantly shorter than that of C-ESD (46 [36.4-64.6] min; p = 0.0014). The technical success rates did not differ between the P-ESD and C-ESD groups (en bloc resection rate, 100% in both groups; complete resection rate, 94.1% and 85.3%, respectively; p = 0.23). The number of injections during P-ESD (7.5 [6-10] times) was significantly higher than during C-ESD (4 [3-5] times; p < 0.001), but the total volume of injected solution during P-ESD (20 [16-26.3] ml) was significantly smaller than during C-ESD (27.5 [20-31.5] ml; p = 0.0019). In multivariate analysis, less ESD experience (odds ratio [OR], 3.9) and selection of C-ESD as the ESD method (OR, 3.8) were independent predictive factors associated with ESD difficulties.ConclusionsCompared with C-ESD, P-ESD had a shorter procedure time but also allowed for notable technical success and safety.

| S-EPMC8828196 | biostudies-literature

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