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. 2021 Apr;9(4):E606-E609.
doi: 10.1055/a-1352-3805. Epub 2021 Apr 13.

Feasibility of ultrathin endoscope for esophageal endoscopic submucosal dissection

Daisuke Kikuchi  1 , Masami Tanaka  1 , Satoshi Nakamura  1 , Kosuke Nomura  1 , Junnosuke Hayasaka  1 , Yorinari Ochiai  1 , Hiroyuki Odagiri  1 , Satoshi Yamashita  1 , Akira Matsui  1 , Shu Hoteya  1
Affiliations

Feasibility of ultrathin endoscope for esophageal endoscopic submucosal dissection

Daisuke Kikuchi et al. Endosc Int Open. 2021 Apr.

Abstract

Background and study aims Endoscopic submucosal dissection (ESD) is widely performed for superficial esophageal cancer, but stricture after extensive resection is a major clinical problem. Using an ultrathin endoscope would enable endoscopists to approach lesions beyond the stricture. We evaluated the feasibility of an ultrathin endoscope for esophageal ESD. Methods To perform ESD with an ultrathin endoscope, we developed a transparent hood and ESD knife. A total of 24 esophageal ESDs were performed by two endoscopists with excised and live porcine esophaguses. A GIF-Q260 J and Dual knife were used in the conventional group and the GIF-XP260NS and a newly developed knife were used in the ultrathin group. En bloc resection rates, perforation rates, and procedure times were compared. Results All 24 lesions were resected en bloc without perforation. The mean procedure time was longer in the ultrathin group, although not significantly so (274.3 ± 81.8 s vs 435.8 ± 313.9 s, respectively; P = 0.22). Conclusion Although the procedure time was longer in the ultrathin group, en bloc resection was performed without any perforation. The findings indicate that esophageal ESD with an ultrathin endoscope is feasible.

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Conflict of interest statement

Competing interests The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Newly developed transparent hood. a Overall view of the new transparent hood. b The ultrathin endoscope mounted with the transparent hood.
Fig. 2
Fig. 2
New ESD knife used in this study. a Overall view of the new ESD knife. b The knife has a maximum diameter of 1.9 mm and protrudes 2 mm from the sheath tip.
Fig. 3
Fig. 3
Endoscopic image of ESD with an ultrathin endoscope. a Endoscopic image of marking for a virtual lesion 15 mm in diameter. b Endoscopic image during submucosal dissection. c Endoscopic image after en bloc resection achieved without perforation.
See this image and copyright information in PMC

References

    1. Hoteya S, Iizuka T, Kikuchi D et al. Benefits of endoscopic submucosal dissection according to size and location of gastric neoplasm, compared with conventional mucosal resection. J Gastroenterol Hepatol. 2009;24:1102–1106. - PubMed
    1. Yamaguchi N, Isomoto H, Nakayama T et al. Usefulness of oral prednisolone in the treatment of esophageal stricture after endoscopic submucosal dissection for superficial esophageal squamous cell carcinoma. Gastrointest Endosc. 2011;73:1115–1121. - PubMed
    1. Hanaoka N, Ishihara R, Takeuchi Y et al. Intralesional steroid injection to prevent stricture after endoscopic submucosal dissection for esophageal cancer: a controlled prospective study. Endoscopy. 2012;44:1007–1011. - PubMed
    1. Iizuka T, Kikuchi D, Yamada A et al. Polyglycolic acid sheet application to prevent esophageal stricture after endoscopic submucosal dissection for esophageal squamous cell carcinoma. Endoscopy. 2015;47:341–344. - PubMed
    1. Ohki T, Yamato M, Ota M et al. Prevention of esophageal stricture after endoscopic submucosal dissection using tissue-engineered cell sheets. Gastroenterology. 2012;143:582–588. - PubMed