Comparison of Needle Knife versus Scissors Forceps for Colorectal Endoscopic Submucosal Dissection: A Prospective Randomized Study

被引:5
|
作者
Yachida, Tatsuo [1 ,2 ]
Kobara, Hideki [1 ]
Kozuka, Kazuhiro [1 ]
Nakatani, Kaho [1 ]
Tada, Naoya [1 ]
Matsui, Takanori [1 ]
Chiyo, Taiga [1 ]
Kobayashi, Nobuya [1 ]
Fujihara, Shintaro [1 ]
Nishiyama, Noriko [1 ]
Kondo, Akihiro [3 ]
Ando, Yasuhisa [3 ]
Okano, Keiichi [3 ]
Nonaka, Wakako [2 ]
Ishikawa, Kaori [2 ]
Masugata, Hisashi [2 ]
Masaki, Tsutomu [1 ]
机构
[1] Kagawa Univ, Fac Med, Dept Gastroenterol & Neurol, Kita, Miki, Kagawa 7610793, Japan
[2] Kagawa Univ, Fac Med, Dept Gen Internal Med, Kita, Miki, Kagawa 7610793, Japan
[3] Kagawa Univ, Fac Med, Dept Gastroenterol Surg, Kita, Miki, Kagawa 7610793, Japan
关键词
endoscopic knife; colorectal endoscopic submucosal dissection; EARLY GASTRIC-CANCER; NEOPLASIA; TUMORS; RESECTION; OUTCOMES;
D O I
10.3390/jcm12062329
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background and Aim: To evaluate the efficacy and safety of a grasping-type knife, called Clutch Cutter (CC), for colorectal endoscopic submucosal dissection (C-ESD). Methods: This was a randomized prospective study. Patients who underwent C-ESD for colorectal neoplasms >20 mm and <50 mm in size were enrolled, dividing into two groups: ESD using needle type of dual knife alone (D-group) and circumferential incision using dual knife followed by submucosal dissection using CC (CC-group). The primary outcome was the self-completion rate. The secondary outcomes were intraoperative complication rate, procedure time, and en bloc resection rate. Results: A total of 45 patients were allocated to the D-group and 43 to the CC-group were allocated. The self-completion rate was higher in the CC-group (87% [39/45] vs. 98% [42/43]). All of the six patients with an incomplete procedure in the D-group were completely resected with CC use. The intraoperative complication rate was not significant in either group (D vs. CC: 2% vs. 0%). The mean procedure time was significantly shorter in the D-group than that in the CC-group (62.0 vs. 81.1 min; p = 0.0036). The en bloc resection rate was 100% in the D-group and 98% in the CC-group. Conclusions: While dual knife use is superior to CC in terms of time efficiency, the use of CC may be a safe and efficacious option for achieving complete C-ESD.
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页数:10
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