Endoscopic submucosal tunnel dissection versus conventional endoscopic submucosal dissection for early gastric cancers: outcomes of 799 consecutive cases in a single institution

Ojima, Toshiyasu; Takifuji, Katsunari; Nakamura, Masaki; Nakamori, Mikihito; Hayata, Keiji; Kitadani, Junya; Yamaue, Hiroki

doi:10.1007/s00464-020-07849-1

Cited by 16 publications

(17 citation statements)

References 11 publications

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“…These studies involved a total of 920 patients (187 from the ESTD group and 733 from the ESD group). The baseline characteristics and quality assessments of the studies are shown in Table 1 (17)(18)(19)(20). Four studies retrospectively analyzed patients who were diagnosed with gastric lesions and treated with ESTD, and collected patients who underwent ESD treatment during the same period to analyze their clinical indicators and prognosis.…”

Section: Resultsmentioning

confidence: 99%

“…Four studies retrospectively analyzed patients who were diagnosed with gastric lesions and treated with ESTD, and collected patients who underwent ESD treatment during the same period to analyze their clinical indicators and prognosis. Ojima's study (20) was a matched study, but because the other three studies were not matched, we included data from unmatched patients. Ojima's study did not give the average value on specimen area, operation time and dissection speed.…”

Section: Resultsmentioning

confidence: 99%

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Clinical Outcomes of Endoscopic Submucosal Tunnel Dissection Vs Endoscopic Submucosal Dissection in Gastric Lesions: a Systematic Review and Meta-analysis

Tan

et al. 2021

Preprint

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Background and objectives: Many studies have verified that endoscopic submucosal dissection (ESD) has prominent advantages in en bloc resection and low recurrence rate. However, ESD also has technical difficulty for some large-area gastric lesions. Endoscopic submucosal tunneling dissection (ESTD) combined the tunnel technique with the traditional ESD technique for treating gastrointestinal mucosal lesions under tunnel endoscopy. This technique has been gradually applied to the treatment of large-scale early cancer and precancerous lesions, and has achieved good results. Yet no meta-analysis has been published, so we performed this study to determine the efficacy and safety of ESTD vs ESD in gastric lesions through clinical outcomes.Methods: We performed the literature search in PubMed, Cochrane Library, Web of Science, Embase, Wanfang, and CNKI dating up to February 9, 2021. Studies comparing the clinical outcomes of ESTD and ESD in gastric lesions were enrolled. The Newcastle-Ottawa Quality Assessment Scale was used to evaluate the quality of these studies. Results: Four articles were included that involved a total of 920 patients (187 from the ESTD group and 733 from ESD group). ESTD has higher en bloc resection and R0 resection rate, faster dissection speed, and lower complication rate. The curative resection rate and recurrence rate of ESTD group is comparable with ESD group.Conclusions: ESTD technique is an effective and safe treatment procedure in gastric lesions, and may be prior to ESD for large gastric lesions.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Clinical Outcomes of Endoscopic Submucosal Tunnel Dissection Vs Endoscopic Submucosal Dissection in Gastric Lesions: a Systematic Review and Meta-analysis

Tan

et al. 2021

Preprint

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“…ESTD was reported to be useful not only for esophageal ESD but also for gastric ESD. A retrospective study evaluating 799 consecutive cases of gastric ESD in single institution showed that resection speed using ESTD was greater than with conventional ESD (19.3 mm 2 /min vs 17.7 mm 2 /min; P = 0.009)[ 62 ]. Perforation was significantly less frequent in ESTD (0.9% vs 6.0%; P = 0.035).…”

Section: Traction Methods Associated With Lesion Sitementioning

confidence: 99%

“…However, the creation of a submucosal tunnel in the stomach may be more difficult compared to the esophagus because the stomach lumen is not straight. It has been reported difficult to form a submucosal tunnel for a lesion located at the pylorus ring or the greater curvature side of the fornix[ 62 ]. On the other hand, lesions located at the cardia, the lesser curvature of the gastric corpus, and the greater curvature of the antrum are reported to be suitable for ESTD[ 63 ].…”

Section: Traction Methods Associated With Lesion Sitementioning

confidence: 99%

Advances in traction methods for endoscopic submucosal dissection: What is the best traction method and traction direction?

Nagata¹

2022

WJG

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Endoscopic submucosal dissection (ESD) has been developed as a treatment for superficial gastrointestinal neoplasms, which can achieve en bloc resection regardless of the lesion size. However, ESD is technically difficult because endoscopists cannot bring their hand into the gastrointestinal tract, unlike surgeons in regular surgery. It is difficult to obtain sufficient tension in the dissection plane and a good field of vision. Therefore, ESD is associated with a long procedure time and a high risk of adverse events in comparison with endoscopic mucosal resection. Traction methods have been developed to provide sufficient tension for the dissection plane and a good field of vision during the ESD procedure. However, traction direction is limited in most traction methods, resulting in insufficient effect in some cases. Although traction direction is considered important, there have been few investigations of its effect. In the first half of this review, important traction methods are discussed, including traction direction. In second half, appropriate traction methods for each organ are considered. Other important considerations for traction method, such as ability to adjust traction strength, interference between traction device and endoscope, and the need for specialized devices are also discussed.

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“…Endoscopic submucosal dissection (ESD) has been described for the management of colorectal lateral spreading tumours (LSTs) [1] with a high complete resection rate and low recurrence rate [2]. A tunnel‐creation method was recently developed to overcome difficulties encountered during ESD for circumferential LSTs [3–5]. To our knowledge, this is the first case of tunnel creation ESD for an anal canal circumferential LST.…”

mentioning

confidence: 99%

Step‐by‐step demonstration of tunnel creation endoscopic submucosal dissection for a lateral spreading anal canal circumferential tumour – a video vignette

Wen

Hsu

2021

Colorectal Disease

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In this video vignette (Video S1 in the Supporting Information) we present a case of laparoscopic-assisted resection of a giant lowgrade appendiceal mucinous neoplasm measuring 18 cm × 8 cm in size. Care must be taken during such a dissection to prevent perforation or spillage of mucin. An appendectomy or partial caecectomy was not possible due to the involvement of the caecum with the appendiceal mass too close to the ileocolic junction. A laparoscopic-assisted right colectomy was performed instead, with high ligation of the ileocolic pedicle and the right branch of the middle colic artery in an extracorporeal fashion with a stapled side-to-side functional end-to-end ileocolic anastomosis. Given the absence of perforation prior to or during the operation, and the final pathology, no surveillance was required. The patient was discharged to a rehabilitation facility on postoperative day 5 for recovery from her preoperative acute embolic cerebrovascular accident.

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Endoscopic submucosal tunnel dissection versus conventional endoscopic submucosal dissection for early gastric cancers: outcomes of 799 consecutive cases in a single institution

Cited by 16 publications

References 11 publications

Clinical Outcomes of Endoscopic Submucosal Tunnel Dissection Vs Endoscopic Submucosal Dissection in Gastric Lesions: a Systematic Review and Meta-analysis

Clinical Outcomes of Endoscopic Submucosal Tunnel Dissection Vs Endoscopic Submucosal Dissection in Gastric Lesions: a Systematic Review and Meta-analysis

Advances in traction methods for endoscopic submucosal dissection: What is the best traction method and traction direction?

Step‐by‐step demonstration of tunnel creation endoscopic submucosal dissection for a lateral spreading anal canal circumferential tumour – a video vignette

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