A Novel Thin-Needle Knife with High-Pressure Waterjet for Colorectal Underwater Endoscopic Submucosal Dissection.

IF 7.5 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Gastrointestinal endoscopy Pub Date : 2025-09-25 DOI:10.1016/j.gie.2025.09.043

Roberto de Sire, Ludovico Alfarone, Antonio Capogreco, Davide Massimi, Vincenzo Vadalà, Luca Brandaleone, Marco Spadaccini, Asma Alkandari, Pradeep Bhandari, Thomas Rosch, Cesare Hassan, Roberta Maselli, Alessandro Repici

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引用次数: 0

Abstract

Background and aims: A novel thin-needle knife with high-pressure waterjet was developed to enhance endoscopic submucosal dissection (ESD) in terms of ease, speed, and safety. We present first clinical results using this new device.

Methods: We included consecutive colorectal underwater ESD cases over 27 months at two therapeutic endoscopy centers. The new knife (HYBRIDknife® flex I-Type, 1.5 mm) was used at the examiner's discretion and compared to various conventional low-pressure waterjet knives. All cases treated with the new knife were matched 1:1 with controls using propensity score analysis based on lesion size, location, morphology, vascular pattern, and operator experience.

Results: Forty matched pairs were analyzed. The mean long axis of ex vivo specimen was 47.2 mm (SD 18.8). Dissection speed was significantly higher with the high-pressure knife (36.7 mm²/min vs 28.2; p<0.0001), while R0 resection rates were comparable (97.5% vs 95%; p=0.8). The benefit appeared more pronounced among less experienced operators and with technically challenging lesions. Three intraprocedural perforations occurred in the control group only, while one case of post-endoscopic coagulation syndrome was observed in each group.

Conclusion: The high-pressure thin-needle knife appears to improve dissection speed with a favorable efficacy and safety profile.

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一种新型高压水刀用于结肠内镜下粘膜下解剖。

背景与目的：研制了一种新型高压水射流薄针刀，以方便、快速和安全的方式加强内镜下粘膜下剥离（ESD）。我们介绍了使用这种新设备的第一个临床结果。方法：选取两个内镜治疗中心连续27个月的结直肠水下ESD病例。新型刀（HYBRIDknife®flex I-Type, 1.5 mm）根据审查员的判断使用，并与各种传统的低压水射流刀进行比较。采用基于病变大小、位置、形态、血管形态和操作经验的倾向评分分析，所有使用新刀治疗的病例与对照组进行1:1匹配。结果：对40对配对进行了分析。离体标本平均长轴为47.2 mm （SD 18.8）。高压刀的解剖速度明显高于高压刀（36.7 mm2/min vs 28.2 mm2/min）。结论：高压细针刀可提高解剖速度，且具有良好的疗效和安全性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Gastrointestinal endoscopy 医学-胃肠肝病学

CiteScore

10.30

自引率

7.80%

发文量

1441

审稿时长

38 days

期刊介绍： Gastrointestinal Endoscopy is a journal publishing original, peer-reviewed articles on endoscopic procedures for studying, diagnosing, and treating digestive diseases. It covers outcomes research, prospective studies, and controlled trials of new endoscopic instruments and treatment methods. The online features include full-text articles, video and audio clips, and MEDLINE links. The journal serves as an international forum for the latest developments in the specialty, offering challenging reports from authorities worldwide. It also publishes abstracts of significant articles from other clinical publications, accompanied by expert commentaries.