Conventional vs. waterjet-assisted endoscopic submucosal dissection in early gastric cancer: a randomized controlled trial

Zhou, Ping‐Hong; Schumacher, Brigitte; Yao, Ling; Xu, Mei‐Dong; Nordmann, Thomas; Cai, Mingjun; Charton, Jean Pierre; Neuhaus, Horst

doi:10.1055/s-0034-1377580

Cited by 36 publications

(40 citation statements)

References 10 publications

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“…However, from our point of view, the device could work just using one anchorage point, and therefore, the procedure would be easier to carry out. Regarding waterjet-assisted ESD using Hybrid Knife, our results are consistent with reports in the only comparative study between waterjet-assisted ESD and conventional ESD [9], which showed waterjet-assisted ESD was both a faster and safer approach than ESD (20 % faster and less need of coagulation forceps). Furthermore, our preliminary experience with MG-ESD even improves …”

Section: Discussionsupporting

confidence: 89%

Electromagnetic Assisted Endoscopic Submucosal Dissection Is More Efficient Than Water-Jet Assisted and Conventional Esd in Experimental Model

Alonso

Sánchez

Belda

et al. 2018

ESGE Days 2018 Accepted Abstracts

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IntroductionEndoscopic submucosal dissection (ESD) is an advanced endoscopic procedure that has enabled en-bloc resection in lesions of any size. Moreover, ESD is a suitable technique for achieving curative resection in fibrotic and difficult polyps, with recurrence rates lower than endoscopic mucosal resection (EMR) [1]. However, in western countries, ESD is not a widely used because of the long learning curve [2], high risk of adverse events (AEs), and amount of time necessary to perform ESD (an average of 54 to 116 minutes per procedure) [3]. Avoidance of inappropriate visualization of the submucosal plane becomes crucial to perform the procedure safely because it can result in inadvertent cutting of blood vessels or the muscular layer. The reason for this drawback of the ESD procedure is that it is done entirely through a single endoscope port, unlike conventional and laparoscopic surgery. To overcome this issue, several traction techniques have been developed [4]. One of them -Magnetic anchor guided-ESD (MG-ESD) -is an attractive alternative, since it poses several advantages compared to other trac-

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Section: Discussionsupporting

confidence: 89%

Electromagnetic Assisted Endoscopic Submucosal Dissection Is More Efficient Than Water-Jet Assisted and Conventional Esd in Experimental Model

Alonso

Sánchez

Belda

et al. 2018

ESGE Days 2018 Accepted Abstracts

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“…HK is a novel electrosurgical instrument whose function is the fusion of a submucosal injection and electrocautery. A previous study demonstrated that ESD using an HK is a faster and simpler procedure and requires fewer accessory changes than conventional ESD [11]. Our cases showed that an HK is also effective in pleuroscopic biopsy when malignant/benign fibrothorax is encountered.…”

Section: Discussionmentioning

confidence: 55%

Semi-Rigid Thoracoscopic Punch Biopsy Using a Hybrid Knife with a High-Pressure Water Jet for the Diagnosis of Pleural Effusions

Yin

Eberhardt²,

Wang³

et al. 2016

Respiration

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Semi-rigid thoracoscopy is an important technique in the definitive diagnosis of pleural diseases with high diagnostic sensitivity and specificity. Obtaining adequate samples from thickened pleura is the most important limitation of semi-rigid thoracoscopy with a standard flexible forceps (SFF) compared with rigid thoracoscopy, especially in patients with mesothelioma or benign fibrothorax. Developing a convenient, efficient and safe biopsy technique to obtain sufficient samples from such patients is a key topic in semi-rigid thoracoscopy. The hybrid knife (HK) is an innovative design fusing high-pressure water injection and a conventional diathermic knife that can allow for the safe resection of a larger lesion during gastrointestinal endoscopic dissection. Here, we describe 3 patients with unexplained pleural effusion who underwent pleural biopsy using an HK to investigate the potential use of the HK as a new pleural biopsy device in semi-rigid thoracoscopy when pleural lesions are difficult to biopsy using an SFF. The biopsies were obtained successfully by HK, and the diagnosis followed. The sizes of the biopsies collected by HK are larger than those collected by SFF. No complications were observed. Electrocautery biopsy using an HK during semi-rigid thoracoscopy has great potential for diagnosing consistent abnormal pleuras, which are difficult to biopsy with an SFF.

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“…A few studies have demonstrated that HK can reduce the frequency of device exchange and the procedure time[19,20]. Zhou et al[19] compared the procedure time, efficacy, and safety of HK-assisted ESD with the conventional technique in patients with early gastric cancer (EGC) in a randomized controlled trial.…”

Section: Discussionmentioning

confidence: 99%

“…Zhou et al[19] compared the procedure time, efficacy, and safety of HK-assisted ESD with the conventional technique in patients with early gastric cancer (EGC) in a randomized controlled trial. They revealed that HK-assisted ESD was as effective and safe as conventional devices (the IT-2 knife, Dual Knife and Hook Knife)-assisted ESD for treating EGC, but the HK group was associated with a shorter procedure time and a lower frequency of device exchange compared with the conventional group[19]. Furthermore, Cai et al[20] also demonstrated that HK achieved shorter procedure time, fewer accessory exchanges, less frequent use of coagulation forceps to control bleeding, and a lower bleeding rate in comparison with a triangle knife.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic submucosal tunnel dissection of upper gastrointestinal submucosal tumors: A comparative study of hook knife vs hybrid knife

Zhou¹,

Tang²,

Ren³

et al. 2017

WJG

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AIMTo compare the efficacy and safety of a hook knife (HO) with a hybrid knife (HK) during endoscopic submucosal tunnel dissection (ESTD) procedure.METHODSBetween August 2012 and December 2015, the ESTD procedure was performed for 83 upper GI submucosal lesions, which originated from the muscularis propria layer identified by upper endoscopy and endoscopic ultrasonography. Of these, 34 lesions were treated by a HO, whereas 49 lesions were treated by a HK. Data regarding age, gender, presenting symptoms, tumor location and size, procedure time, complications, en bloc resection rate and others were analyzed and compared between the two groups.RESULTSThere were no significant differences in the age, gender, presenting symptoms and tumor location between the two groups. ESTD was successfully completed in all the patients, and no case was converted to laparoscopy. The mean procedure time was significantly shorter in the HK group than in the HO group (41.3 ± 20.3 min vs 57.2 ± 28.0 min, P = 0.004). The mean frequency of device exchange was 1.4 ± 0.6 in the HK group and significantly less than 3.3 ± 0.6 in the HO group (P < 0.001). The differences in tumor size and histopathological diagnoses were not significant between the two groups (P = 0.813, P = 0.363, respectively). Both groups had an equal en bloc resection rate and complete resection rate. Additionally, the complication rate was similar between the two groups (P = 0.901). During the follow-up, no recurrence occurred in either group.CONCLUSIONWe demonstrate for the first time that HO and HK do not differ in efficacy or safety, but HK reduces the frequency of device exchange and procedure time.

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Conventional vs. waterjet-assisted endoscopic submucosal dissection in early gastric cancer: a randomized controlled trial

Abstract: Waterjet-assisted ESD and conventional ESD are comparably effective and safe techniques for the local treatment of EGC. The waterjet-assisted technique is a faster and simpler procedure and requires fewer accessory changes compared with conventional ESD.

Cited by 36 publications

References 10 publications

Electromagnetic Assisted Endoscopic Submucosal Dissection Is More Efficient Than Water-Jet Assisted and Conventional Esd in Experimental Model

Electromagnetic Assisted Endoscopic Submucosal Dissection Is More Efficient Than Water-Jet Assisted and Conventional Esd in Experimental Model

Semi-Rigid Thoracoscopic Punch Biopsy Using a Hybrid Knife with a High-Pressure Water Jet for the Diagnosis of Pleural Effusions

Endoscopic submucosal tunnel dissection of upper gastrointestinal submucosal tumors: A comparative study of hook knife vs hybrid knife

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