Usefulness of clip traction in the early phase of esophageal endoscopic submucosal dissection

Ota, Masaho; Nakamura, Tsutomu; Hayashi, Kazuhiko; Ohki, Takeshi; Narumiya, Kosuke; Sato, Takuya; Shirai, Yuji; Kudo, Kenji; Yamamoto, Masakazu

doi:10.1111/j.1443-1661.2012.01286.x

Cited by 46 publications

(44 citation statements)

References 8 publications

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“…Various retraction methods have been reported to facilitate dissection. The "clip traction" method is one of the easiest techniques reported (31,32). It involves the use of a long thread of suture tied to an endoscopic clip, which is applied on the oral side of the lesion after mucosal incision and the suture retrieved in the mouth.…”

Section: Endoscopic Submucosal Dissection (Esd)mentioning

confidence: 99%

Endoscopic diagnosis and management of early squamous cell carcinoma of esophagus

Yip

Chiu

2017

J. Thorac. Dis.

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In recent years, diagnosis of early squamous cell carcinoma (SCC) of the esophagus has been increasingly emphasized. Utilization of image enhanced technology such as narrow band imaging (NBI) and magnification endoscopy allowed detailed examination of the esophageal mucosa. Different patterns of intrapapillary capillary loops (IPCL) have been proven to accurately diagnose and predict the depth of invasion of the tumors. In addition, the application of endoscopic submucosal dissection (ESD) has enabled safe en bloc resection of esophageal lesions. Promising results of ESD have been published and ESD is now the standard of therapy in early SCC of esophagus.

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Section: Endoscopic Submucosal Dissection (Esd)mentioning

confidence: 99%

Endoscopic diagnosis and management of early squamous cell carcinoma of esophagus

Yip

Chiu

2017

J. Thorac. Dis.

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“…Based on these findings, the patient's esophageal MALT lymphoma was in stage I (Lugano classification). To confirm the histological diagnosis and to achieve complete resection of the lesion, we carried out ESD with a clip traction technique . The procedure was completed in 50 min.…”

Section: Case Reportmentioning

confidence: 99%

Primary esophageal mucosa‐associated lymphoid tissue lymphoma treated by endoscopic submucosal dissection

Kudo

Ota

Narumiya

et al. 2013

Digestive Endoscopy

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Primary esophageal mucosa-associated lymphoid tissue (MALT) lymphoma is rare. There have been few reports about early primary esophageal MALT lymphoma being treated endoscopically. The clinical profile of primary esophageal MALT lymphoma is currently unclear, so it is important to accumulate more information about early esophageal MALT lymphoma. To achieve early detection of esophageal MALT lymphoma, we need more accurate knowledge and information about the macroscopic and morphological features of this tumor. Endoscopic resection is one of the most effective treatments. With respect to the lateral and vertical margins of the resected specimen, endoscopic submucosal dissection (ESD) may be superior to endoscopic mucosal resection for treating early esophageal MALT lymphoma. Here we report the macroscopic appearance of the tumor which is the first successful case of ESD for early esophageal MALT lymphoma.

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“…Several mucosal traction methods have been employed in esophageal and gastric ESD, which could effectively assist in ESD. In this study, our method also had a good traction effect.…”

Section: Discussionmentioning

confidence: 99%

Snare combined with endoclips in endoscopic submucosal dissection with mucosal traction for gastroesophageal neoplasia

Zhang

Yao

Cai

et al. 2018

J of Gastro and Hepatol

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Background and Aim Mucosal traction as a “second hand” in endoscopic submucosal dissection (ESD) is very helpful for ESD operators. The efficacy of using a snare combined with endoclips to assist in ESD (SC‐ESD) was evaluated whether it could achieve peroral external traction (PET) and peroral internal traction (PIT) and real‐time adjustment of mucosal traction position. This study aimed to preliminarily evaluate its feasibility. Methods A snare was fixed using endoclips to the incised mucosal flap that was intended for dissection. Subsequently, the snare was adjusted to achieve mucosal traction. This study included 54 gastroesophageal neoplasias in 54 consecutive patients who underwent SC‐ESD. The operative and clinical data were retrospectively collected. Results Peroral external tractions were performed for 22 esophageal neoplasias, and PETs and PITs were performed for 32 gastric neoplasias. The median (interquartile range) sizes of lesions were 4.3 (2.5) and 4.2 (2.1) cm, operation times were 73.4 (43.8) and 60.0 (45.2) min, and submucosal dissection times were 27.0 (32.0) and 31.0 (34.5) min in the esophagus and stomach, respectively. Mucosal traction position could be effectively adjusted by fixing the snare to the incised mucosal flap intended for dissection during SC‐ESD. All lesions in the esophagus and stomach were completely resected, with R0 resection rates of 100%. Besides postoperative bleeding in a patient with gastric neoplasia, no intraoperative and postoperative perforations occurred. Conclusions SC‐ESD seems to be feasible for resecting gastroesophageal neoplasia, and two types of mucosal tractions (PET and PIT) could be effectively achieved during SC‐ESD. Further prospective comparative study with a large sample is warranted.

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Usefulness of clip traction in the early phase of esophageal endoscopic submucosal dissection

Abstract: Clip traction shortens operating time and is safer in esophageal ESD. Clip traction is recommended as a useful auxiliary procedure.

Cited by 46 publications

References 8 publications

Endoscopic diagnosis and management of early squamous cell carcinoma of esophagus

Endoscopic diagnosis and management of early squamous cell carcinoma of esophagus

Primary esophageal mucosa‐associated lymphoid tissue lymphoma treated by endoscopic submucosal dissection

Snare combined with endoclips in endoscopic submucosal dissection with mucosal traction for gastroesophageal neoplasia

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