Multiloop as a novel traction method in accelerating colorectal endoscopic submucosal dissection
Multiloop as a novel traction method in accelerating colorectal endoscopic submucosal dissection
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DOI：
10.1016/j.gie.2019.08.042
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发表时间：
2020-01-01
影响因子：
7.7
通讯作者：
Nakase, Hiroshi
中科院分区：
文献类型：
--
作者：
Suzuki, Yuichiro;Tanuma, Tokuma;Nakase, Hiroshi
背景和目的：据报道，牵引方法可以加速内镜粘膜下剥离术（ESD）。我们使用多环（M-loop）法作为结直肠 ESD 的牵引方法，并记录粘膜下剥离时间（SDT）和粘膜下剥离速度（SDS）。方法：2018 年 1 月至 8 月，我们使用 M-loop 法进行结直肠 ESD 手术，计时持续时间并记录结果。两名专家和八名非专家进行了手术，手术在日本三级内窥镜中心进行。 结果：共有 50 名患者接受了使用 M 环法的结直肠 ESD 治疗。平均 SDT 为 42.1 +/- 4.16 分钟，平均 SDS 为 28.0 +/- 2.89 mm(2)/分钟。专家的平均 SDS 为 38.9 +/- 6.9 mm(2)/分钟，非专家的平均 SDS 为 25.3 +/- 3.1 mm(2)/分钟。 100%的病例实现了整块切除。有 3 起不良事件和不良结果。结论：M 环法牵引改善了结直肠 ESD 的 SDS。该方法可以成为辅助结直肠 ESD 的有效工具。需要通过与传统 ESD 的直接比较来进一步评估 M 环方法的实用性。
Background and Aims: Traction methods have been reported to speed up endoscopic submucosal dissection (ESD). We used the multiloop (M-loop) method as a traction method for colorectal ESD and recorded the submucosal dissection time (SDT) and submucosal dissection speed (SDS).Methods: From January to August 2018, we used the M-loop method for colorectal ESD procedures and timed the duration and recorded the outcomes. Two experts and eight nonexperts performed the procedures, which were carried out at a tertiary endoscopic center in Japan.Results: A total of 50 patients were treated by colorectal ESD using the M-loop method. The mean SDT was 42.1 +/- 4.16 minutes and the mean SDS was 28.0 +/- 2.89 mm(2)/minutes. The mean SDS was 38.9 +/- 6.9 mm(2)/minutes for experts and 25.3 +/- 3.1 mm(2)/minutes for nonexperts. En bloc resection was achieved in 100% of cases. There were 3 adverse events and unfavorable outcomes.Conclusions: Traction by the M-loop method improved SDS in colorectal ESD. The method can be an effective tool to assist colorectal ESD. Further evaluation of the usefulness of the M-loop method is required in direct comparison with conventional ESD.