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Endoscopic submucosal dissection for gastrointestinal tumor (esophagus,stomach,colon) using the traction device.

ABSTRACT: Interventions: countertraction usings the rubber band traction device Primary outcome(s): Procedural success Study Design: Single arm Non-randomized

DISEASE(S): Esophageal Tumors, Gastric Tumors, Colorectal Tumors

PROVIDER: 2623559 | ecrin-mdr-crc |

REPOSITORIES: ECRIN MDR

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Chemically assisted endoscopic submucosal dissection(CA-ESD) with a rubber band tissue traction device

Project description:Interventions: countertraction usings the rubber band traction device and using mesna as a submucosal injection solution. Primary outcome(s): Procedural success Study Design: Single arm Non-randomized

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Endoscopic submucosal dissection by using a new traction device.

Project description:Video 1Patient with a history of gastric ectopic pancreas and epigastric pain. We illustrate the endoscopic submucosal dissection of the ectopic pancreas using a new traction device, the ProdiGi traction wire. Using this device, we were able to resect the lesion en bloc with no adverse events.

| S-EPMC8645833 | biostudies-literature

Endoscopic submucosal dissection of appendiceal lesions by using a novel adjustable traction device: A-TRACT-2

Project description:Video Video 1 Dissections of appendiceal lesions using A-TRACT-2.

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Multiloop method for traction during colorectal endoscopic submucosal dissection.

Project description: Not available

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Impact of Traction Direction in Traction-Assisted Gastric Endoscopic Submucosal Dissection (with Videos).

Project description:BackgroundThe impact of traction direction in traction-assisted gastric endoscopic submucosal dissection (ESD) has not been adequately investigated. A clip with line (CWL) is a classical single-directional traction device. In contrast, a spring and loop with clip (SLC; S-O clip) is a newly developed multidirectional traction device.AimsTo investigate the impact of traction direction in gastric ESD by comparing the procedure-related outcomes of CWL-assisted ESD (CWL-ESD) and SLC-assisted ESD (SLC-ESD).MethodsWe retrospectively examined 140 patients with superficial gastric neoplasms who underwent SLC-ESD or CWL-ESD by a single ESD expert during November 2017-September 2020. The traction direction was classified based on the endoscopic finding in the following five categories: proximal, diagonally proximal, vertical, diagonally distal, and distal. In SLC-ESD, we set vertical traction, using the multidirectional traction function. Propensity score matching was conducted to compensate for the differences in lesion size, injection function of electrosurgical knife, ulcerative lesion, lesion location, and lesion position. The primary outcome was gastric ESD procedure time.ResultsPropensity score matching created 42 pairs. The median gastric ESD procedure time in the SLC-ESD group was significantly shorter than that in the CWL-ESD group (28.3 min vs. 51.0 min, P = 0.022). All traction direction in the SLC-ESD group was vertical, while only 16.7% in the CWL-ESD group. En bloc resection was attained without perforation in all the patients in both groups.ConclusionOur findings suggest that SLC can provide vertical traction, which reduces the gastric ESD procedure time. Multidirectional traction devices can provide vertical traction in most cases of gastric ESD, unlike single-directional traction devices. Vertical traction may reduce the gastric ESD procedure time.

| S-EPMC9971682 | biostudies-literature

Efficacy and Safety of Multi Loop Traction Device-assisted Colorectal Endoscopic Submucosal Dissection: A Multicenter, Randomized Clinical Trial

Project description:Interventions: 1) MLTD-ESD group Colorectal endoscopic submucosal dissection (ESD) is performed using the Multi Loop Traction Device (MLTD). The number of MLTD used in a single session is not limited. The conversion of the allocated therapeutic method is permitted. If the MLTD is ineffective for more than 10 minutes, the MLTD can be removed. 2) Conventional ESD group ESD is completed using a standard therapeutic strategy that does not involve the use of traction devices. The conversion of the allocated therapeutic method is permitted. The MLTD can be used if the endoscopist determines that the traction device has been required for more than 10 minutes. Primary outcome(s): Dissection speed (area resected [mm^2]/duration in minutes) Study Design: Parallel Randomized

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Multi-loop traction device facilitates gastric endoscopic submucosal dissection: ex vivo pilot study and an inaugural clinical experience.

Project description:BackgroundEndoscopic submucosal dissection (ESD) is technically difficult and requires considerable training. The authors have developed a multi-loop traction device (MLTD), a new traction device that offers easy attachment and detachment. We aimed to evaluate the utility of MLTD in ESD.MethodsThis ex vivo pilot study was a prospective, block-randomized, comparative study of a porcine stomach model. Twenty-four lesions were assigned to a group that undertook ESD using the MLTD (M-ESD group) and a group that undertook conventional ESD (C-ESD group) to compare the speed of submucosal dissection. In addition, the data of consecutive 10 patients with eleven gastric lesions was collected using electronic medical records to clarify the inaugural clinical outcomes of gastric ESD using MLTD.ResultsThe median (interquartile range) speed of submucosal dissection in the M-ESD and C-ESD groups were 141.5 (60.9-177.6) mm2/min and 35.5 (20.8-52.3) mm2/min, respectively; submucosal dissection was significantly faster in the M-ESD group (p < 0.05). The rate of en bloc resection and R0 resection was 100% in both groups, and there were no perforation in either group. The MLTD attachment time was 2.5 ± 0.9 min and the MLTD extraction time was 1.0 ± 1.1 min. Clinical outcomes of MLTD in gastric ESD were almost the same as those of ex vivo pilot study.ConclusionsMLTD increased the speed of submucosal dissection in ESD and was similarly effective when used by expert and trainee endoscopists without perforation. MLTD can potentially ensure a safer and faster ESD.

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Removal of submucosal embedded fish bone in the esophagus with endoscopic submucosal dissection.

Project description: Not available

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A prospective study investigating the efficacy and safety of traction-band-assisted endoscopic closure for mucosal defect after colorectal endoscopic submucosal dissection: A multi-center trial (TBEC Trial)

Project description:Interventions: Traction-band-assisted endoscopic closure (TBEC) for mucosal defect after colorectal ESD Primary outcome(s): Complete closure of mucosal defect Study Design: Single arm Non-randomized

| 2740973 | ecrin-mdr-crc

Development and clinical usability of a new traction device "medical ring" for endoscopic submucosal dissection of early gastric cancer.

Project description:BackgroundAlthough various traction devices exist for endoscopic submucosal dissection (ESD), the effects of the material used in the devices on the human body has not been considered. Moreover, there has been no report on a device that facilitates dissection both on the oral and anal side of the lesion. We made a traction device that has no deleterious effects on the body and is noninvasive, easy to use, and enables a bilateral approach in ESD. We report the process of its creation and a prospective evaluation of its usage in actual ESD procedures.MethodsThis study is prospective case control study. Thirty-seven patients for whom the device would be used were consecutively and prospectively enrolled (device used group). Control subjects in whom the device would not be used and who had lesions matched for size and location with those of the device used group were randomly selected (device not used group). Both groups were classified into three subgroups according to treatment difficulty: group A: easy; group B: intermediate; and group C: difficult. The dissection time per cm(2) in each group was examined.ResultsDissection times in the device not used group/device used group were as follows: group A, 5.8/2.1 min/cm(2) (p < 0.01); group B, 6.1/3.8 min/cm(2) (p < 0.05); and group C, 7.9/3.6 min/cm(2) (p < 0.01), respectively.ConclusionsThe newly developed medical ring was shown to be feasible and safe and allowed excellent visualization through suitable tension and facilitated rapid gastric ESD.

| S-EPMC3751377 | biostudies-literature

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