Endoscopic Submucosal Dissection for Early Gastric Cancer using the Clutch Cutter: a large single-center experience

Akahoshi, Kazuya; Motomura, Yasuaki; Kubokawa, Masaru; Gibo, Junya; Kinoshita, Nobukatsu; Osada, Shigeki; Tokumaru, Kayo; Hosokawa, Taizou; Tomoeda, Naru; Otsuka, Yoshihiro; Matsuo, M.; Oya, Masafumi; Koga, Hidenobu; Nakamura, Kazuhiko

doi:10.1055/s-0034-1392509

Cited by 22 publications

(32 citation statements)

References 30 publications

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“…There was no uncontrollable intraoperative bleeding in our previous reports on ESD[ 11 - 17 ]. We were able to quickly and easily stop intraoperative bleeding using the CC[ 15 ] without changing the device for the entire gastrointestinal tract. In the present study, we did not perform any unexpected incisions.…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes of Clutch Cutter endoscopic submucosal dissection for older patients with early gastric cancer

Otsuka

Akahoshi

Yasunaga

et al. 2017

WJGO

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AIMTo evaluate the clinical outcome of endoscopic submucosal dissection using the Clutch Cutter (ESDCC) in older patients.METHODSWe reviewed 232 consecutive patients with early gastric cancer who underwent ESDCC between June 2010 and February 2014 at Aso Iizuka Hospital. We divided patients into two groups according to age: Older patients (> 80 years, n = 64) and non-older patients (≤ 80 years, n = 168). We retrospectively compared the prevalence rates of pre-existing comorbidities, anticoagulant therapy, en bloc resection, mean duration of hospitalization, incidence of ESDCC-related complications, change in performance status (PS) before and after ESDCC, and financial cost of admission.RESULTSThe older group comprised 64 patients with a mean age of 84.1 years, and the non-older group comprised 168 patients with a mean age of 69.5 years. Older patients had significantly more pre-existing comorbidities than did non-older patients, specifically heart disease (P < 0.05). The en bloc resection rate in non-older patients was significantly higher than that in older patients (100% vs 95.3%, P = 0.02). There were no significant differences between the older and non-older groups in the incidence of ESDCC-related complications (i.e., postoperative bleeding and perforation) and the post-ESDCC change in PS. There were also no significant differences between the older and non-older groups in the mean duration of hospitalization (11.4 and 10.7 d, respectively) and financial cost of admission (657040 JPY and 574890 JPY, respectively).CONCLUSIONESDCC has a good clinical outcome in older patients.

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Section: Discussionmentioning

confidence: 99%

Clinical outcomes of Clutch Cutter endoscopic submucosal dissection for older patients with early gastric cancer

Otsuka

Akahoshi

Yasunaga

et al. 2017

WJGO

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“…VIO 300D (ERBE Elektromedizin, GmbH, Tübingen, Germany) was used as the electrical power source. The ESD procedure was described in detail in previous reports[7,12,13]. In brief, marking dots were made 2 mm outside the lesion.…”

Section: Methodsmentioning

confidence: 99%

“…ESD with Clutch Cutter (ESD-C) may then become an option of endo-knife for ESD. Favorable outcomes of ESD-C have been reported, including in a large single-center study with single arm trial[7-9]. However, few reports exist showing the comparison between scissors-type and non-scissors-type knives in the technical outcomes of ESD, which have been limited to non-experts in inclusion criteria[10,11].…”

Section: Introductionmentioning

confidence: 99%

Clutch Cutter knife efficacy in endoscopic submucosal dissection for early gastric neoplasms

Hayashi

Esaki

Suzuki

et al. 2018

WJGO

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AIMTo compare the outcomes of endoscopic submucosal dissection (ESD) for gastric neoplasms using Clutch Cutter (ESD-C) or other knives (ESD-O).METHODSThis was a single-center retrospective study. Gastric neoplasms treated by ESD between April 2016 and October 2017 at Kitakyushu Municipal Medical Center were reviewed. Multivariate analyses and propensity score matching were used to reduce biases. Covariates included factors that might affect outcomes of ESD, including age, sex, underlying disease, anti-thrombotic drugs use, tumor location, tumor position, tumor size, tumor depth, tumor morphology, tumor histology, ulcer (scar), and operator skill. The treatment outcomes were compared among two groups. The primary outcome was ESD procedure time. Secondary outcomes were en bloc, complete, and curative resection rates, and adverse events rates including perforation and delayed bleeding.RESULTSA total of 155 patients were included in this study; 44 pairs were created by propensity score matching. Background characteristics were quite similar among two groups after matching. Procedure time was significantly shorter for ESD-C (median; 49 min) than for ESD-O (median; 88.5 min) (P < 0.01). However, there was no significant difference in treatment outcomes between ESD-C and ESD-O including en bloc resection rate (100% in both groups), complete resection rate (100% in both groups), curative resection rate (86.4% vs 88.6%, P = 0.730), delayed bleeding (2.3% vs 6.8%, P = 0.62) and perforation (0% in both groups).CONCLUSIONESD-C achieved shorter procedure time without an increase in complication risk. Therefore, ESD-C could become an effective ESD option for gastric neoplasms.

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“…The width and length of the jaws is 0.4-mm and 5-mm respectively[5-9]. The jaws can be rotated 360 degrees and the outer edges are insulated to minimize the electrical risk.…”

Section: Methodsmentioning

confidence: 99%

Endoscopic submucosal dissection of gastric adenomas using the clutch cutter

Akahoshi¹,

Kubokawa²,

Gibo³

et al. 2017

WJGE

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AIMTo evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) using the clutch cutter (CC) (ESD-CC) for gastric adenoma (GA).METHODSFrom June 2007 to August 2015, 122 consecutive patients with histological diagnoses of GA from specimens resected by ESD-CC were enrolled in this prospective study. The CC was used for all ESD steps (marking, mucosal incision, submucosal dissection, and hemostatic treatment), and its therapeutic efficacy and safety were assessed.RESULTSBoth the en-bloc resection rate and the R0 resection rate were 100% (122/122). The mean surgical time was 77.4 min, but the time varied significantly according to tumor size and location. No patients suffered perforation. Post-ESD-CC bleeding occurred in six cases (4.9%) that were successfully resolved by endoscopic hemostatic treatment.CONCLUSIONESD-CC is a technically efficient, safe, and easy method for resecting GA.

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Endoscopic Submucosal Dissection for Early Gastric Cancer using the Clutch Cutter: a large single-center experience

Cited by 22 publications

References 30 publications

Clinical outcomes of Clutch Cutter endoscopic submucosal dissection for older patients with early gastric cancer

Clinical outcomes of Clutch Cutter endoscopic submucosal dissection for older patients with early gastric cancer

Clutch Cutter knife efficacy in endoscopic submucosal dissection for early gastric neoplasms

Endoscopic submucosal dissection of gastric adenomas using the clutch cutter

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