Randomized study of two endo-knives for endoscopic submucosal dissection of esophageal cancer

Hiromitsu Kanzaki, Ryu Ishihara, Takashi Ohta, Kengo Nagai, Fumi Matsui, Takeshi Yamashina, Masao Hanafusa, Sachiko Yamamoto, Noboru Hanaoka, Yoji Takeuchi, Koji Higashino, Noriya Uedo, Hiroyasu Iishi, Masaharu Tatsuta

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Abstract

Objectives: Settings for endoscopic submucosal dissection (ESD) of esophageal cancer have not been standardized, and no studies have directly compared ESD devices in humans.Methods: We conducted a randomized study to compare the performances of two different endo-knives, the Flush knife and Mucosectom, for esophageal ESD in 48 lesions. All procedures were initiated by two endoscopists, who were assisted by senior endoscopists with verbal advice. In the Flush-knife group, mucosal incision with a 2-mm Flush knife was followed by submucosal dissection using a 1-mm Flush knife. In the Mucosectom group, mucosal incision with a 2-mm Flush knife was followed by submucosal dissection with a Mucosectom. The primary outcome variable was the procedure time required for submucosal dissection. The secondary outcome variables were total procedure time, self-completion rates, and adverse events.Results: Total procedure time in the Mucosectom group was significantly shorter than in the Flush-knife group (57±21 vs. 83±27 min, respectively; P<0.001). The submucosal-dissection time in the Mucosectom group was significantly shorter than in the Flush-knife group (40±18 vs. 61±23 min, respectively; P<0.001). The self-completion rate in the Mucosectom group was slightly higher than in the Flush-knife group, but the difference was not significant (91.7% vs. 75%, respectively; P=0.25). One perforation and one postoperative bleeding occurred in the Flush-knife group, both of which were treated successfully by endoscopic treatment. Conclusions: The Mucosectom reduced the procedure and submucosal-dissection times of esophageal ESD, without increasing adverse events.

Original languageEnglish
Pages (from-to)1293-1298
Number of pages6
JournalAmerican Journal of Gastroenterology
Volume108
Issue number8
DOIs
Publication statusPublished - Aug 1 2013
Externally publishedYes

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ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Kanzaki, H., Ishihara, R., Ohta, T., Nagai, K., Matsui, F., Yamashina, T., Hanafusa, M., Yamamoto, S., Hanaoka, N., Takeuchi, Y., Higashino, K., Uedo, N., Iishi, H., & Tatsuta, M. (2013). Randomized study of two endo-knives for endoscopic submucosal dissection of esophageal cancer. American Journal of Gastroenterology, 108(8), 1293-1298. https://doi.org/10.1038/ajg.2013.161